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目的了解黄冈市结核病患者耐药的特点及流行现状,为今后结核病防控工作提供参考依据。方法以黄冈市耐多药项目实施期间登记的可疑病例作为研究对象,用比例法对利福平(RFP)、异烟肼(INH)、链霉素(SM)、乙胺丁醇(EMB)4种药进行药物敏感性试验。结果 1 487例肺结核患者痰标本培养阳性1 063例,经菌型鉴定1 044株(初治632例,复治412例)为结核分枝杆菌,其中总耐药254株,总耐药率为24.33%,初治患者及复治患者总耐药率分别为12.50%、42.50%;耐多药142株,耐多药率为13.60%,初治患者及复治患者耐多药率分别为4.59%、27.43%,单耐药75例,单耐药率为7.18%,多耐药37例,多耐药率为3.54%;任何耐药顺位是RFP(17.62%)、INH(17.43%)、SM(14.66%)、EMB(7.28%),其中初治患者耐药顺位是INH 8.07%、SM 7.44%、RFP 6.96%、EMB 2.69%,复治患者耐药顺位是RFP 33.98%、INH 31.80%、SM 25.73%、EMB14.32%;初、复治患者各种耐药情况比较有统计学意义。结论黄冈市肺结核患者总耐药低于全国平均水平,但耐多药和复治患者各种耐药均高于全国水平,说明结核病防控工作形势严峻,特别是要加强初治患者的管理以减少耐药结核病的发生。
Objective To understand the characteristics and prevalence status of drug resistance in tuberculosis patients in Huanggang City and provide reference for future tuberculosis prevention and control work. Methods Susceptible cases registered during the multi-drug resistant project in Huanggang City were selected as the research objects. Ratified RFP, INH, EMB, Four kinds of drugs for drug susceptibility testing. Results A total of 1 063 cases were positive for sputum samples from 1 477 pulmonary tuberculosis patients. One hundred and forty-four strains were identified (including 632 newly diagnosed cases and 412 re-treated ones) by Mycobacterium tuberculosis. The total drug resistance was 254 and the total drug resistance rate was 24.33%. The total drug resistance rates of newly diagnosed patients and retreatment patients were 12.50% and 42.50%, respectively. 142 multi-drug resistant patients were MDR-resistant and the multidrug resistance rate was 13.60%. The multi-drug-resistant rates of newly diagnosed patients and retreated patients were 4.59 %, 27.43%, 75 cases of single drug resistance, 7.18% of single drug resistance, 37 cases of multi-drug resistance, multi-drug resistance rate of 3.54%; RFS (17.62%), INH , SM (14.66%) and EMB (7.28%). The drug resistance of IN patients was INH 8.07%, SM 7.44%, RFP 6.96% and EMB 2.69% INH 31.80%, SM 25.73%, EMB14.32%; the initial and retreatment patients with various resistance were statistically significant. Conclusion The total drug resistance of tuberculosis patients in Huanggang City is lower than the national average level, but the resistance of all patients in MDR and retreatment is higher than the national level, indicating that the situation of tuberculosis prevention and control work is grim, especially in the management of newly diagnosed patients Reduce the occurrence of drug-resistant TB.