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
2013年
9期
667-670
,共4页
李永文%李新旭%耿红%陶武威%于春宝
李永文%李新旭%耿紅%陶武威%于春寶
리영문%리신욱%경홍%도무위%우춘보
分枝杆菌,结核%抗药性,多药%结核,肺
分枝桿菌,結覈%抗藥性,多藥%結覈,肺
분지간균,결핵%항약성,다약%결핵,폐
Mycobacterium tuberculosis%Drug resistance,multiple%Tuberculosis,pulmonary
目的 分析山东省MTB耐药流行状况,并与1997年的监测结果相比较,为制定耐药结核病控制措施提供科学依据.方法 对2004年10月至2011年12月山东省结核病耐药监测哨点送检的5916例涂阳肺结核痰培养阳性标本进行一线抗结核药物敏感性试验,有检测结果的为5542例,其中男4198例,女1344例；年龄15 ～ 92岁,平均(51±20)岁,≤29岁组1304例,30 ～ 59岁组2106例,≥60岁组2132例；初治4332例(占78.2％),复治1210例(占21.8％).各组间率的比较采用x2检验.结果 山东省MTB总耐药率为19.4％(1075/5542),较1997年的总耐药率(23.4％,288/1229)有明显下降(x2=10.193,P＜0.01).单耐药率、耐多药率和多耐药率分别为11.3％(629/5542)、3.7％(203/5542)和4.4％ (243/5542)；初治患者耐药率为19.0％(822/4332),其中62.7％(515/822)的初治耐药患者为单耐药；复治患者耐药率为20.9％ (253/1210),其中54.9％(139/253)的复治耐药患者为耐多药或多耐药；耐药患者单耐药率为58.5％(629/1075),初治患者占76.5％(822/1075);初治患者耐多药率为2.9％ (124/4332),复治患者耐多药率为6.5％(79/1210),差异有统计学意义(x2 =36.032,P ＜0.01)；男性与女性的耐药率分别为19.9％(834/4198)和17.9％(241/1344),初治耐药率分别为19.5％(641/3287)和17.3％(181/1045),复治耐药率分别为21.2％(193/911)和20.1％(60/299),差异均无统计学意义(x2值为0.170 ～2.452,均P＞0.05).结论 近年山东省的耐药结核病控制工作成效显著,MTB耐药以初治患者为主,因此耐药结核病控制工作应注重早期发现、有效治疗和加强管理,以控制耐药MTB的传播.
目的 分析山東省MTB耐藥流行狀況,併與1997年的鑑測結果相比較,為製定耐藥結覈病控製措施提供科學依據.方法 對2004年10月至2011年12月山東省結覈病耐藥鑑測哨點送檢的5916例塗暘肺結覈痰培養暘性標本進行一線抗結覈藥物敏感性試驗,有檢測結果的為5542例,其中男4198例,女1344例；年齡15 ～ 92歲,平均(51±20)歲,≤29歲組1304例,30 ～ 59歲組2106例,≥60歲組2132例；初治4332例(佔78.2％),複治1210例(佔21.8％).各組間率的比較採用x2檢驗.結果 山東省MTB總耐藥率為19.4％(1075/5542),較1997年的總耐藥率(23.4％,288/1229)有明顯下降(x2=10.193,P＜0.01).單耐藥率、耐多藥率和多耐藥率分彆為11.3％(629/5542)、3.7％(203/5542)和4.4％ (243/5542)；初治患者耐藥率為19.0％(822/4332),其中62.7％(515/822)的初治耐藥患者為單耐藥；複治患者耐藥率為20.9％ (253/1210),其中54.9％(139/253)的複治耐藥患者為耐多藥或多耐藥；耐藥患者單耐藥率為58.5％(629/1075),初治患者佔76.5％(822/1075);初治患者耐多藥率為2.9％ (124/4332),複治患者耐多藥率為6.5％(79/1210),差異有統計學意義(x2 =36.032,P ＜0.01)；男性與女性的耐藥率分彆為19.9％(834/4198)和17.9％(241/1344),初治耐藥率分彆為19.5％(641/3287)和17.3％(181/1045),複治耐藥率分彆為21.2％(193/911)和20.1％(60/299),差異均無統計學意義(x2值為0.170 ～2.452,均P＞0.05).結論 近年山東省的耐藥結覈病控製工作成效顯著,MTB耐藥以初治患者為主,因此耐藥結覈病控製工作應註重早期髮現、有效治療和加彊管理,以控製耐藥MTB的傳播.
목적 분석산동성MTB내약류행상황,병여1997년적감측결과상비교,위제정내약결핵병공제조시제공과학의거.방법 대2004년10월지2011년12월산동성결핵병내약감측초점송검적5916례도양폐결핵담배양양성표본진행일선항결핵약물민감성시험,유검측결과적위5542례,기중남4198례,녀1344례；년령15 ～ 92세,평균(51±20)세,≤29세조1304례,30 ～ 59세조2106례,≥60세조2132례；초치4332례(점78.2％),복치1210례(점21.8％).각조간솔적비교채용x2검험.결과 산동성MTB총내약솔위19.4％(1075/5542),교1997년적총내약솔(23.4％,288/1229)유명현하강(x2=10.193,P＜0.01).단내약솔、내다약솔화다내약솔분별위11.3％(629/5542)、3.7％(203/5542)화4.4％ (243/5542)；초치환자내약솔위19.0％(822/4332),기중62.7％(515/822)적초치내약환자위단내약；복치환자내약솔위20.9％ (253/1210),기중54.9％(139/253)적복치내약환자위내다약혹다내약；내약환자단내약솔위58.5％(629/1075),초치환자점76.5％(822/1075);초치환자내다약솔위2.9％ (124/4332),복치환자내다약솔위6.5％(79/1210),차이유통계학의의(x2 =36.032,P ＜0.01)；남성여녀성적내약솔분별위19.9％(834/4198)화17.9％(241/1344),초치내약솔분별위19.5％(641/3287)화17.3％(181/1045),복치내약솔분별위21.2％(193/911)화20.1％(60/299),차이균무통계학의의(x2치위0.170 ～2.452,균P＞0.05).결론 근년산동성적내약결핵병공제공작성효현저,MTB내약이초치환자위주,인차내약결핵병공제공작응주중조기발현、유효치료화가강관리,이공제내약MTB적전파.
Objective To analyze the present epidemic status of drug-resistant Mycobacterium tuberculosis (MTB) in Shandong Province of China,as compared with findings of survey for drug-resistant MTB in 1997,and therefore to provide valuable data for making the current control policy of drug-resistant MTB.Methods From October 2004 to December 2011,the culture positive sputum samples of all 5916 new registered sputum smear-positive TB patients at the county-level TB dispensaries were tested for drug susceptibility.Finally 5542 cases with test results were included in the analysis.Of the total cases,4198 were male and 1344 were female.The age range of the patients were 15 to 92 years old and the average age was (51 ±20) years old,among whom,1304 were ≤ 29 years old,2106 were from 30 to 59 years old and 2132 were ≥ 60 years old.Of all the cases,4332 (78.2％) only received initial treatment and 1210 (21.8％) received retreatment.The SPSS 13.0 was used for statistical analysis and x2 test was used to compare category,gender,and age groups of patients.Results The total drug resistance (TDR) rate was 19.4％ (1075/5542),which was lower than 23.4％ (288/1229) in 1997 in Shandong Province (x2 =10.193,P ＜ 0.01).The rates of single drug resistance (SDR),multidrug resistance (MDR) and poly-drug resistance (PDR) were 11.3％ (629/5542),3.7％ (203/5542) and 4.4％ (243/5542),respectively.The TDR rate in patients with initial treatment was 19.0％ (822/4332),and 62.7％(515/822) of which was SDR.The TDR rate of patients with retreatment was 20.9％ (253/1210),and 54.9％ (139/253) of which tended to be MDR or PDR.Among TDR patients,those with initial treatment accounted for 76.5％ (822/1075) and SDR patients accounted for 58.5％ (629/1075).The MDR rate of patients with initial treatment was 2.9％ (124/4332) and the rate of patients with retreatment was 6.5％(79/1210),the differences being significant (x2 =36.032,P ＜0.01).The TDR rate,initial TDR rate,and retreatment TDR rate in males were 19.9％ (834/4198),19.5％ (641/3287),and 21.2％ (193/911),respectively,as compared to 17.9％ (241/1344),17.3％ (181/1045),and 20.1％ (60/299) in females,the differences being not significant (x2 =0.170-2.452,P ＞ 0.05).Conclusions The drug-resistant TB control work in Shandong Province has made great achievements in recent years.However,patients with initial treatment were more likely to have drug-resistant MTB.Therefore the future control work should focus on early detection,effective treatment and management to control the spread of drugresistant MTB.
