临床荟萃
臨床薈萃
림상회췌
CLINICAL FOCUS
2014年
6期
617-620
,共4页
结核,肺%抗药性%分枝杆菌%监测
結覈,肺%抗藥性%分枝桿菌%鑑測
결핵,폐%항약성%분지간균%감측
tuberculosis,pulmonary%drug resistance%mycobacterium%testing
目的：了解青岛市胸科医院住院肺结核患者结核分枝杆菌耐药情况，制定科学的防治对策。方法采用世界卫生组织制定的结核分枝杆菌耐药监测方案进行结核分枝杆菌耐药监测，使用绝对浓度法对住院的1950例痰标本人型结核分枝杆菌的肺结核患者耐药性进行测定。结果1950例痰标本阳性肺结核患者中，全敏感1120例，耐药830例（42．5％）。其中原发耐药425例（51．2％），获得性耐药405例（48．7％）。在3年中各药原发耐药率分别为：异烟肼47．3％，利福平24．0％，链霉素41．4％，乙胺丁醇24．2％，对氨基水杨酸4．5％，阿米卡星0．7％，丙硫异烟胺5．6％，左氧氟沙星9．4％，对氨基水杨酸异烟肼0．7％；在425例原发耐药病例中，单耐药结核病253例（59．5％）；多耐药结核病101例（23．7％）；耐多药结核病71例（16．4％）。结论青岛市胸科医院住院肺结核患者耐药现状仍十分严重，加强对全市结核防控工作管理，加大结核分枝杆菌耐药监测，实现抗结核防治方案的统一管理，全程督导化疗势在必行。
目的：瞭解青島市胸科醫院住院肺結覈患者結覈分枝桿菌耐藥情況，製定科學的防治對策。方法採用世界衛生組織製定的結覈分枝桿菌耐藥鑑測方案進行結覈分枝桿菌耐藥鑑測，使用絕對濃度法對住院的1950例痰標本人型結覈分枝桿菌的肺結覈患者耐藥性進行測定。結果1950例痰標本暘性肺結覈患者中，全敏感1120例，耐藥830例（42．5％）。其中原髮耐藥425例（51．2％），穫得性耐藥405例（48．7％）。在3年中各藥原髮耐藥率分彆為：異煙肼47．3％，利福平24．0％，鏈黴素41．4％，乙胺丁醇24．2％，對氨基水楊痠4．5％，阿米卡星0．7％，丙硫異煙胺5．6％，左氧氟沙星9．4％，對氨基水楊痠異煙肼0．7％；在425例原髮耐藥病例中，單耐藥結覈病253例（59．5％）；多耐藥結覈病101例（23．7％）；耐多藥結覈病71例（16．4％）。結論青島市胸科醫院住院肺結覈患者耐藥現狀仍十分嚴重，加彊對全市結覈防控工作管理，加大結覈分枝桿菌耐藥鑑測，實現抗結覈防治方案的統一管理，全程督導化療勢在必行。
목적：료해청도시흉과의원주원폐결핵환자결핵분지간균내약정황，제정과학적방치대책。방법채용세계위생조직제정적결핵분지간균내약감측방안진행결핵분지간균내약감측，사용절대농도법대주원적1950례담표본인형결핵분지간균적폐결핵환자내약성진행측정。결과1950례담표본양성폐결핵환자중，전민감1120례，내약830례（42．5％）。기중원발내약425례（51．2％），획득성내약405례（48．7％）。재3년중각약원발내약솔분별위：이연정47．3％，리복평24．0％，련매소41．4％，을알정순24．2％，대안기수양산4．5％，아미잡성0．7％，병류이연알5．6％，좌양불사성9．4％，대안기수양산이연정0．7％；재425례원발내약병례중，단내약결핵병253례（59．5％）；다내약결핵병101례（23．7％）；내다약결핵병71례（16．4％）。결론청도시흉과의원주원폐결핵환자내약현상잉십분엄중，가강대전시결핵방공공작관리，가대결핵분지간균내약감측，실현항결핵방치방안적통일관리，전정독도화료세재필행。
Objective To find out the situation of drug-resistant tuberculosis patients in Qingdao Chest Hospital,to draft scientific prevention and control strategy.Methods Using the World-Health Organization (WHO) mycobacterium tuberculosis drug resistance monitoring scheme to test drug susceptibility of mycobacterium tuberculosis,using the absolute concentration method to determine the resistance of 1 950 cases of culture positive pulmonary tuberculosis patients in the hospital.Results In 1 950 cases of culture positive pulmonary tuberculosis patients,1 120 cases were all sensitive,830 cases were resistant(42.5%).There were 425 cases of primary drug resistance,405 cases of acquired drug resistance.In the three years,the drug resistant rate was respectively:isoniazid 47.3%,rifampicin 24.0%,streptomycin 41.4%,ethambutol 24.2%,paraaminosalicylicacid 4.5%,amikacin 0.7%, prothionamide 5.6%,levofloxacin 9.4%,isoniazid aminosalicylate 0.7%;Among 425 primary drug-resistant cases, there were 253 cases of drug-resistant tuberculosis(59.5%),101 cases of polydrug-resistant tuberculosis(23.7%),71 cases of multidrug-resistant tuberculosis(16.4%).Conclusion The data obtained strongly suggests that the present situation of resistant tuberculosis in the hospital is still very serious.It is imperative to strengthen the management of tuberculosis prevention and control,and expand the testing points of Mycobacterium tuberculosis drug resistance,and supervise pulmonary tuberculosis under full-course management of the tuberculosis.
