实用心脑肺血管病杂志
實用心腦肺血管病雜誌
실용심뇌폐혈관병잡지
PRACTICAL JOURNAL OF CARDIAC CEREBRAL PNEUMAL AND VASCULAR DISEASE
2014年
8期
36-38
,共3页
钟丽云%李静%许爱东%黄国楼
鐘麗雲%李靜%許愛東%黃國樓
종려운%리정%허애동%황국루
结核,肺%广泛耐药结核%惠州市
結覈,肺%廣汎耐藥結覈%惠州市
결핵,폐%엄범내약결핵%혜주시
Tuberculosis,pulmonary%Extensively drug-resistant tuberculosis%Huizhou city
目的：分析惠州市最新肺结核耐药监测结果及趋势，为进一步完善本地区肺结核防控对策提供依据。方法2013年1月-2014年5月，对惠州市各县区涂阳培阳患者进行抽样调查，本研究共监测6个试点，共纳入肺结核患者638例。对患者进行痰菌分离培养，采用比例法进行一线药及二线药耐药性检测。结果本次抽样菌株总耐药率为45.1%，其中初治总耐药率为33.1%、复治总耐药率为60.8%。初治涂阳患者单一耐药率〔12.9%（82/638）〕低于复合耐药率〔32.3%（206/638）〕，总耐多药率低于复治涂阳患者（P﹤0.05）。初、复治涂阳患者异烟肼（INH， H）﹢利福平（RFP，R）耐药率均为最高。单一任意耐药顺序为：H（194）﹥R（131）﹥链霉素（SM，S）（131）﹥氧氟沙星（OFX）（84）﹥乙胺丁醇（EMB，E）（33）﹥左氧氟沙星（LOF）（32）﹥卡那霉素（KM）（31）﹥对氨基水杨酸（PAS）（15）﹥卷曲霉素（CM）（14）﹥丁胺卡那（AM）（10）﹥丙硫异烟胺（TH1321）（8）。结论惠州市肺结核耐药情况复杂多样，耐多药肺结核有上升趋势，面临耐多药、广泛耐药肺结核的挑战，应重点关注H、R、S这3种一线抗结核药物的合理使用，以减少耐药菌株的产生和传播，降低耐药肺结核发生率。
目的：分析惠州市最新肺結覈耐藥鑑測結果及趨勢，為進一步完善本地區肺結覈防控對策提供依據。方法2013年1月-2014年5月，對惠州市各縣區塗暘培暘患者進行抽樣調查，本研究共鑑測6箇試點，共納入肺結覈患者638例。對患者進行痰菌分離培養，採用比例法進行一線藥及二線藥耐藥性檢測。結果本次抽樣菌株總耐藥率為45.1%，其中初治總耐藥率為33.1%、複治總耐藥率為60.8%。初治塗暘患者單一耐藥率〔12.9%（82/638）〕低于複閤耐藥率〔32.3%（206/638）〕，總耐多藥率低于複治塗暘患者（P﹤0.05）。初、複治塗暘患者異煙肼（INH， H）﹢利福平（RFP，R）耐藥率均為最高。單一任意耐藥順序為：H（194）﹥R（131）﹥鏈黴素（SM，S）（131）﹥氧氟沙星（OFX）（84）﹥乙胺丁醇（EMB，E）（33）﹥左氧氟沙星（LOF）（32）﹥卡那黴素（KM）（31）﹥對氨基水楊痠（PAS）（15）﹥捲麯黴素（CM）（14）﹥丁胺卡那（AM）（10）﹥丙硫異煙胺（TH1321）（8）。結論惠州市肺結覈耐藥情況複雜多樣，耐多藥肺結覈有上升趨勢，麵臨耐多藥、廣汎耐藥肺結覈的挑戰，應重點關註H、R、S這3種一線抗結覈藥物的閤理使用，以減少耐藥菌株的產生和傳播，降低耐藥肺結覈髮生率。
목적：분석혜주시최신폐결핵내약감측결과급추세，위진일보완선본지구폐결핵방공대책제공의거。방법2013년1월-2014년5월，대혜주시각현구도양배양환자진행추양조사，본연구공감측6개시점，공납입폐결핵환자638례。대환자진행담균분리배양，채용비례법진행일선약급이선약내약성검측。결과본차추양균주총내약솔위45.1%，기중초치총내약솔위33.1%、복치총내약솔위60.8%。초치도양환자단일내약솔〔12.9%（82/638）〕저우복합내약솔〔32.3%（206/638）〕，총내다약솔저우복치도양환자（P﹤0.05）。초、복치도양환자이연정（INH， H）﹢리복평（RFP，R）내약솔균위최고。단일임의내약순서위：H（194）﹥R（131）﹥련매소（SM，S）（131）﹥양불사성（OFX）（84）﹥을알정순（EMB，E）（33）﹥좌양불사성（LOF）（32）﹥잡나매소（KM）（31）﹥대안기수양산（PAS）（15）﹥권곡매소（CM）（14）﹥정알잡나（AM）（10）﹥병류이연알（TH1321）（8）。결론혜주시폐결핵내약정황복잡다양，내다약폐결핵유상승추세，면림내다약、엄범내약폐결핵적도전，응중점관주H、R、S저3충일선항결핵약물적합리사용，이감소내약균주적산생화전파，강저내약폐결핵발생솔。
Objective To analyze the new monitoring results of tuberculosis drug resistance and its trends in Huizhou, to provide the basis for further prevention and control measures. Methods From January 2013 to May 2014,638 tuberculosis patients from 6 monitoring places were chosen by sample survey,they were diagnosed by positive smear culture. All patients had sputum isolated culture,and the resistance to first-line anti-tuberculosis drugs and second-line anti-tuberculosis drugs were detected by proportional method. Results The total drug resistant rate was 45. 1%, thereinto the initial resistant rate was 33. 1%,acquired drug resistant rate was 60. 8%. The single drug resistant rate of newly treated patients〔12. 9%( 82/638)〕was lower than that of complex durgs resistant rate〔32. 3%(206/638)〕,total MDR rate was lower than that of retreat patients (P﹤0. 05). The resistant rate of isoniazid(INH,H) ﹢ rifampicin(RFP,R)is highest in newly treated patients and retreat patients. The order of single drug resistant rate was:H(194) ﹥R(131) ﹥ streptomycin(SM,S)(131) ﹥ofloxacin (OFX)(84) ﹥ethambutol(EMB,E)(33) ﹥levofloxacin(LOF)(32) ﹥ kanamycin(KM)(31) ﹥4-amino sali-cylic acid(PAS)(15) ﹥capreomycin(CM) (14) ﹥amikacin(AM) (10) ﹥propylthiouracil isonicotinoyl amine ( TH1321)(8). Conclusion Tuberculosis drug resistance in Huizhou is complex and various,and MDR rate is rising,brings the the challenge of MDR tuberculosis and extensively drug-resistant tuberculosis. We should focus on the usage of H,R,S of first-line anti-tuberculosis drugs,to reduce the drug resistant strains of tuberculosis and drug resistant tuberculosis.
