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[目的]分析普陀区外来人口与户籍人口肺结核患者耐药性的异同。[方法]收集普陀区肺结核门诊痰涂片及结核分枝杆菌培养均阳性的病例资料,采取随即抽样的方法将其分为两组,外来人口组598例,户籍人口组600例。痰涂片阳性患者采用绝对浓度法进行结核分枝杆菌培养,并对分离菌株进行4种抗结核药耐药性测定。[结果]598例外来人口肺结核病例中痰培养阳性患者耐药率为28.3%,其中初治患者耐药率为19.6%,复治患者耐药率为48.5%,治愈率为84.6%。600例户籍人口肺结核病例中痰培养阳性患者的耐药率为23.2%,其中初治患者耐药率为15%,复治患者耐药率为41.3%,治愈率为87.0%,两组间总耐药率差异无统计学意义。外来人口男、女复治肺结核患者耐药率都比户籍人口高,且以青壮年为主,户籍人口耐药病例主要发生在中老年。外来及户籍人口初治耐药病例都以耐单药为主,复治病例则以耐多药为主。[结论]外来人口和户籍人口肺结核均处于高耐药状态,应引起足够重视。继续贯彻现代结核病控制策略,进行全程规则化疗及耐药性监测,以减少耐药结核病例的发生。
[Objective] To analyze the similarities and differences in drug resistance of pulmonary tuberculosis among migrant population and registered population in Putuo District. [Method] The sputum smear of tuberculosis clinics in Putuo District and the positive cases of Mycobacterium tuberculosis culture were collected and divided into two groups according to the random sampling method. There were 598 cases of foreign population and 600 cases of household registration population. The sputum smear-positive patients were cultured with Mycobacterium tuberculosis by the absolute concentration method, and the antibacterial resistance of the four isolates was tested. [Results] The resistance rate of sputum culture positive patients in 598 cases of pulmonary tuberculosis cases was 28.3%. Among them, the rate of drug resistance was 19.6% in initial treatment and 48.5% in cure. The cure rate was 84.6%. The resistance rate of sputum culture positive patients with pulmonary tuberculosis among 600 registered permanent residents was 23.2%, of which 15% were resistant to initial treatment, 41.3% were resistant to retreatment, and the cure rate was 87.0% No significant difference in drug resistance rates. Residents population Male and female retreatment tuberculosis patients resistant rate than the household population is high, and mainly young and middle-aged, census population drug-resistant cases occurred mainly in the elderly. The population of newly arrived and registered permanent residents was resistant to monotherapy, while the cases of multidrug-resistant were mainly multi-drug resistant. [Conclusions] Pulmonary tuberculosis of migrant population and household population are all highly resistant and should be given enough attention. Continue to implement the modern control strategy for tuberculosis and conduct regular chemotherapy and drug resistance monitoring to reduce the incidence of drug-resistant TB cases.