中华结核和呼吸杂志
中華結覈和呼吸雜誌
중화결핵화호흡잡지
Chinese Journal of Tuberculosis and Respiratory Diseases
2001年
2期
83-86
,共4页
唐神结%肖和平%夏祥新%吴福蓉%沙魏
唐神結%肖和平%夏祥新%吳福蓉%沙魏
당신결%초화평%하상신%오복용%사위
分支杆菌,结核%药物耐受性%年龄组
分支桿菌,結覈%藥物耐受性%年齡組
분지간균,결핵%약물내수성%년령조
目的了解近阶段不同年龄组结核分支杆菌耐药情况，探讨当前耐药性发展趋势。方法根据年龄将1 948例肺结核患者分为青年组（18～39岁），中年组（40～59岁）和老年组（≥60岁）；采用绝对浓度法进行抗结核药物耐药性测定。结果青年组、中年组、老年组原发耐药率分别为36.1%、46.8%和40.2%，各组间差异无显著性（P>0.05）。青年组、中年组、老年组获得性耐药率分别为81.3%、70.1%和62.1%，青年组和老年组差异有显著性（P=0.019 6）。原发耐药频度各年龄组从高到低均依次为H、E、S、R，中年组耐R率最高达10.6%。获得性耐药顺序青、中年组为H、R、S、E，老年组为H、S、R、E，其中青年组耐R率最高达63.6%。原发耐多药率以中年组最高为5.3%，显著高于青年组（P=0.011 2）和老年组（P=0.008 5）。获得性耐多药率青年组最高达55.2%，显著高于中年组（P=0.031 9）和老年组(P<0.001)。既往用药1～3个月者耐药率为58.7%，显著高于未用药者（P<0.001）和用药＜1月者（P=0.047 2），而未用药和用药＜1月者耐药率差异无显著性（P=0.292 9）。此外，在各年龄组中青年组发生耐药的速度最快。结论不同年龄组无论原发耐药还是获得性耐药均有所不同，建议应重视不同年龄组耐药率的监测，为修订国家结核病规划提供依据。
目的瞭解近階段不同年齡組結覈分支桿菌耐藥情況，探討噹前耐藥性髮展趨勢。方法根據年齡將1 948例肺結覈患者分為青年組（18～39歲），中年組（40～59歲）和老年組（≥60歲）；採用絕對濃度法進行抗結覈藥物耐藥性測定。結果青年組、中年組、老年組原髮耐藥率分彆為36.1%、46.8%和40.2%，各組間差異無顯著性（P>0.05）。青年組、中年組、老年組穫得性耐藥率分彆為81.3%、70.1%和62.1%，青年組和老年組差異有顯著性（P=0.019 6）。原髮耐藥頻度各年齡組從高到低均依次為H、E、S、R，中年組耐R率最高達10.6%。穫得性耐藥順序青、中年組為H、R、S、E，老年組為H、S、R、E，其中青年組耐R率最高達63.6%。原髮耐多藥率以中年組最高為5.3%，顯著高于青年組（P=0.011 2）和老年組（P=0.008 5）。穫得性耐多藥率青年組最高達55.2%，顯著高于中年組（P=0.031 9）和老年組(P<0.001)。既往用藥1～3箇月者耐藥率為58.7%，顯著高于未用藥者（P<0.001）和用藥＜1月者（P=0.047 2），而未用藥和用藥＜1月者耐藥率差異無顯著性（P=0.292 9）。此外，在各年齡組中青年組髮生耐藥的速度最快。結論不同年齡組無論原髮耐藥還是穫得性耐藥均有所不同，建議應重視不同年齡組耐藥率的鑑測，為脩訂國傢結覈病規劃提供依據。
목적료해근계단불동년령조결핵분지간균내약정황，탐토당전내약성발전추세。방법근거년령장1 948례폐결핵환자분위청년조（18～39세），중년조（40～59세）화노년조（≥60세）；채용절대농도법진행항결핵약물내약성측정。결과청년조、중년조、노년조원발내약솔분별위36.1%、46.8%화40.2%，각조간차이무현저성（P>0.05）。청년조、중년조、노년조획득성내약솔분별위81.3%、70.1%화62.1%，청년조화노년조차이유현저성（P=0.019 6）。원발내약빈도각년령조종고도저균의차위H、E、S、R，중년조내R솔최고체10.6%。획득성내약순서청、중년조위H、R、S、E，노년조위H、S、R、E，기중청년조내R솔최고체63.6%。원발내다약솔이중년조최고위5.3%，현저고우청년조（P=0.011 2）화노년조（P=0.008 5）。획득성내다약솔청년조최고체55.2%，현저고우중년조（P=0.031 9）화노년조(P<0.001)。기왕용약1～3개월자내약솔위58.7%，현저고우미용약자（P<0.001）화용약＜1월자（P=0.047 2），이미용약화용약＜1월자내약솔차이무현저성（P=0.292 9）。차외，재각년령조중청년조발생내약적속도최쾌。결론불동년령조무론원발내약환시획득성내약균유소불동，건의응중시불동년령조내약솔적감측，위수정국가결핵병규화제공의거。
Objective To investigate drug resistance of Mycobacterium tuberculosis in different age group in recent five years， and to analyze the trends of drug resistance at present.Methods 1 948 cases of pulmonary tuberculosis with culture-positive were divided into youth group (18～39 years)， middle age group (40～59 years) and old age group (≥60 years). All of the strains of Mycobacterium tuberculosis were tested for resistance to INH， RFP， SM and EMB by the absolute concentration method.Results The rate of primary drug resistance in youth group was 36.1%， in middle age group 46.8%， in old age group 40.2%， there were no significant differences among them(P>0.05). The rate of acquired drug resistance was higher in youth group than that in old age group (P=0.019 6). The primary resistance rate to RFP in middle age group was 10.6%， much higher than that in youth group and in old age group. The acquired resistance rate to RFP in youth group was 63.6%， higher than that in middle age group and in old age group. The rate of primary multi-drug resistance in middle age group was 5.3%， higher than that in youth group (P=0.011 2) and in old age group (P=0.008 5). The rate of acquired multi-drug resistance in youth group was 55.2%， higher than that in middle age group (P=0.031 9) and in old age group (P<0.001). The drug resistance rate in using drugs 1～3 months group was 58.7%， higher than that in never using drug group (P<0.001) and in using drugs＜1 month group(P=0.047 2). The drug resistance rate had no significant difference between never using drug group and using drugs＜1 month group. The emergency of drug resistance in youth group was fastest in all age groups.Conclusions Primary drug resistance or acquired drug resistance varies in different age group.It is suggested that the surveillance of drug resistance in different age group should be taken seriously， so as to provide an important basis for revising National Tuberculosis Programme (NTP).
