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目的对开封市耐药结核病流行状况进行基线调查,了解本地结核病疫情以及控制现状,为制定本市耐多药结核病的防控策略提供参考依据。方法对201 1年3月至2012年8月间开封市全部县区结防机构登记报告的1 033例涂阳肺结核患者的痰标本,由市级结防机构统一进行痰培养,培养阳性者进行抗结核药物的敏感性试验。对910例有检测结果的结核分枝杆菌耐药情况进行分析,其中男性707例,女203例,性别比为3.48:1;年龄14~91岁,平均(49.48±16.09)岁;初治涂阳748例(占82.20%),复治涂阳162例(占17.80%);对检测结果使用SPSS16.0进行统计分析。结果开封市涂阳肺结核患者总耐药率为24.84%(226/910)低于2007-2008年全国结核病耐药性基线调查耐药率39.12%(1 537/3 929)(x~2=65.10,P<0.05);涂阳患者中总耐多药率6.15%(56/910)和初治患者耐多药率2.27%(17/148)低于全国耐药基线调查的耐多药率8.32%(x~2=14.23,P<0.05)和5.71%(x~2=8.21,P<0.05;);而复治涂阳患者耐多药率24.07%(39/162)与全国耐多药率25.64%相比差异无统计学意义(x~2=0.12,P>0.05)。结论近年开封市耐药结核分枝杆菌流行的总体情况低于全国平均水平,结核分枝杆菌耐药以复治患者为主,因此耐药结核病控制工作应注重早期发现、加强初治肺结核患者的有效治疗与管理,避免耐药结核分枝杆菌的发生,有效控制耐药结核病传播。
Objective To investigate the prevalence of drug-resistant TB (TB) in Kaifeng and to find out the current situation of TB control in our city and to provide reference for the prevention and control of MDR-TB in this city. Methods A total of 1 033 sputum smear positive smear-positive sputum specimens of patients with smear positive pulmonary tuberculosis (TB) registered in all districts and counties in Kaifeng City between March 2011 and August 2012 were collected by sputum culture institutions Antituberculosis drug sensitivity test. Analysis of the drug resistance of Mycobacterium tuberculosis in 910 cases with detection results showed that there were 707 males and 203 females, the sex ratio was 3.48: 1; the age ranged from 14 to 91 years (mean, 49.48 ± 16.09 years) Yang 748 cases (82.20%), retreatment smear positive 162 cases (accounting for 17.80%); the test results using SPSS16.0 statistical analysis. Results The total drug resistance rate of smear-positive pulmonary tuberculosis in Kaifeng City was 24.84% (226/910), which was lower than the baseline resistance rate of 39.12% (1337/3 929) (x ~ 2 = 65.10) in the national TB drug resistance survey in 2007-2008 , P <0.05). The prevalence of MDR in smear-positive patients was 6.15% (56/910) and that of patients in newly diagnosed patients was 2.27% (17/148), which was lower than the MDR of the national drug resistance baseline survey of 8.32 (x ~ 2 = 14.23, P <0.05) and 5.71% (x ~ 2 = 8.21, P <0.05); while the rate of multidrug resistance was 24.07% (39/162) There was no significant difference in the rate of 25.64% (x ~ 2 = 0.12, P> 0.05). Conclusion In recent years, the overall prevalence of drug-resistant Mycobacterium tuberculosis in Kaifeng City is lower than the national average level. Mycobacterium tuberculosis is mainly drug-resistant in patients with drug-resistant Mycobacterium tuberculosis. Therefore, the control of drug-resistant tuberculosis should pay attention to early detection and strengthen the treatment of patients with newly-diagnosed tuberculosis Effective treatment and management, to avoid the occurrence of drug-resistant Mycobacterium tuberculosis, effective control of drug-resistant TB transmission.