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目的通过对2011-2015年期间四川省肺结核患者结核菌耐药特征分析,进一步掌握该省耐药结核病流行特点,为制定“十三五”防治规划提供参考依据。方法回顾性调查2011年1月至2015年12月四川省12个市(州)108个县(市、区)中所有痰涂片阳性的肺结核患者及耐多药结核病高危人群痰标本分离结核分枝杆菌对异烟肼(INH)、利福平(RFP)、氧氟沙星(OFX)和卡那霉素(KM)的药物敏感性,对其耐药情况和流行特征进行对比分析。结果筛查的6158例患者中,总耐药率为43.10%,初治患者耐药率为32.00%,复治患者耐药率为53.97%,差异有统计学意义(χ2=303,P<0.01),任何耐药顺位为INH>OFX>RFP>KM。耐多药结核病患者占耐药患者比例为30.97%,广泛耐药结核病患者占耐多药结核病患者的18.13%。男性患者耐药率为45.19%,高于女性(χ2=21.06,P<0.01);农村患者耐药率为45.77%,高于城市;30~60岁年龄组患者耐药率高于其他年龄组。结论四川省痰涂片阳性的肺结核患者及耐多药结核病高危人群耐药率高于全国水平,且高于2010年该省第五次流行病学调查水平。45~60岁农村男性患者是耐药防控的重点人群。
Objective To analyze the characteristics of drug-resistant tuberculosis in patients with tuberculosis in Sichuan province during 2011-2015 and further grasp the epidemiological characteristics of drug-resistant tuberculosis in this province and provide a reference for the formulation of prevention and control plan for the “Thirteen Five-Year Plan”. Methods Retrospective investigation of sputum smear positive sputum smear-positive tuberculosis patients in 108 counties (cities and districts) from January 2011 to December 2015 in 12 cities of Sichuan Province The drug sensitivity of mycobacteria to isoniazid (INH), rifampicin (RFP), ofloxacin (OFX) and kanamycin (KM) was compared with their drug resistance and epidemiological characteristics. Results Of the 6158 patients screened, the total drug resistance rate was 43.10%, the initial drug resistance rate was 32.00% and the re-treatment rate was 53.97%, the difference was statistically significant (χ2 = 303, P <0.01 ), Any resistance ranking was INH> OFX> RFP> KM. MDR-TB patients accounted for 30.97% of drug-resistant patients, and those with XDR-TB accounted for 18.13% of MDR-TB patients. The resistance rate in male patients was 45.19%, higher than that in women (χ2 = 21.06, P <0.01). The drug resistance rate in rural patients was 45.77%, higher than that in urban areas. The drug resistance rates in 30-60 years old group were higher than those in other age groups . Conclusions The rates of drug resistance in sputum smear positive TB patients and those at high risk of multidrug - resistant tuberculosis in Sichuan Province are higher than the national level and higher than the level of the fifth epidemiological survey in the province in 2010. 45 to 60-year-old rural male patients are drug-resistant control of key populations.