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目的了解北京市朝阳区结核病患者的耐药情况,为临床结核病治疗及该地区结核防控提供相应的依据。方法采用WHO推荐的比例法对分离培养阳性的376株菌株,进行SM、INH、RFP、EMB 4种一线抗结核药物的敏感性检测及菌种鉴定。结果共分离鉴定出结核分枝杆菌367株,其中272株为全敏感株,95株耐药,总耐药率为25.89%,其中初治耐药率为24.55%(82/334),复治耐药率为39.39%(13/33);初治MDR为6.29%(21/334),复治MDR为15.15%(5/33);初治患者耐药率依次为SM>INH>RFP>EMB,复治患者耐药率为SM=RFP>INH>EMB;耐药率在性别间差异具有统计学意义(P<0.05),在年龄及户籍地中差异无统计学意义(P>0.05)。结论在对本区结核病患者的治疗中建议使用EMB等耐药率较低的药物,同时要结合药敏试验的结果,对不同患者采用更加合理的治疗方案。
Objective To understand the drug resistance of patients with tuberculosis in Chaoyang District, Beijing, and to provide a basis for the clinical treatment of tuberculosis and prevention and control of tuberculosis in the area. Methods 376 strains were isolated and cultured according to the proportion method recommended by WHO. The sensitivity, detection and identification of 4 first-line anti-TB drugs of SM, INH, RFP and EMB were tested. Results A total of 367 strains of Mycobacterium tuberculosis were isolated and identified, of which 272 strains were fully sensitive and 95 strains were resistant, with a total resistance rate of 25.89%. The initial drug resistance rate was 24.55% (82/334) The drug resistance rate was 39.39% (13/33) in the initial treatment group, 6.29% (21/334) in the initial treatment group and 15.15% (5/33) in the retreatment group. The drug resistance rates of the newly diagnosed patients were SM> INH> RFP> The resistance rate of EMB and retreatment patients was SM = RFP> INH> EMB. There was no significant difference in sex and age (P> 0.05) . Conclusions In the treatment of tuberculosis patients in this area, it is recommended to use drugs with lower drug resistance such as EMB. In combination with the results of drug susceptibility test, a more reasonable treatment plan should be adopted for different patients.