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目的了解石家庄市2004—2008年门诊就诊初治肺结核病人的耐药情况及影响因素,为制定耐药结核病的防治对策提供参考依据。方法对2004—2008年在门诊就诊的初治肺结核病人痰培养阳性的744份痰标本进行菌型鉴定及5种抗结核药物(INH、RFP、EMB、PAS、SM)的耐药性试验。结果744份痰培养阳性,平均耐药率为36.02%,耐多药率为11.69%;5种抗结核药物的耐药顺位H(21.25%)、R(20.02%)、S(19.62%)、E(11.29%)、P(10.48%),以耐单药和耐2种药物为主(57.84%);各年龄组不同性别耐药率不存在差别(P>0.05),结核病患者耐药的高峰年龄在20～39岁。结论加强医防合作,采取得力措施落实短程化疗(DOTS)管理,规范化疗方案是减少耐药发生的有效措施。
Objective To understand the drug resistance and influencing factors of newly diagnosed pulmonary tuberculosis patients in outpatient clinics in Shijiazhuang from 2004 to 2008 and provide reference for making prevention and treatment of drug-resistant tuberculosis. Methods 744 sputum samples from sputum cultures of newly diagnosed tuberculosis patients attending outpatient clinics in 2004-2008 were tested for their bacteriological characteristics and drug resistance of 5 anti-TB drugs (INH, RFP, EMB, PAS, SM). Results There were 744 positive sputum cultures with an average resistance rate of 36.02% and a resistance rate of 11.69%. The resistance of five anti-TB drugs was 21.25%, R (20.02%), S (19.62%), , E (11.29%) and P (10.48%), respectively, with single drug resistance and two kinds of drug resistance (57.84%). There was no difference in sex drug resistance rates among all age groups (P> 0.05) The peak age of 20 to 39 years old. Conclusion Strengthening medical cooperation, adopting effective measures to implement DOTS management and standardizing chemotherapy regimens are effective measures to reduce drug resistance.