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目的分析邯郸市初、复治肺结核患者耐药状况,为结核病的临床和控制提供参考依据。方法对邯郸市2013年间登记的348例涂阳肺结核患者痰标本经培养阳性并作菌株鉴定。用比例法对结核分枝杆菌进行抗异烟肼(H)、利福平(R)、链霉素(S)和乙胺丁醇(E)的耐药性检测,并分析结核分枝杆菌的耐药状况。结果 348例结核分枝杆菌感染的涂阳肺结核患者中,总耐药率30.75%,耐多药率14.37%。复治组耐药率及耐多药率均高于初治组,差异有统计学意义(χ2=67.41,χ2=52.11,P<0.01)。对4种抗结核药物的耐药频度由高到低依次为H(42.53%)、S(34.20%)、R(27.59%)、E(20.98%)。初治组对4种抗结核药物的耐药率较复治组低,差异均有统计学意义(P<0.01)。结论邯郸市肺结核患者结核分枝杆菌耐药发生率高,需进一步加强耐药结核病的检测和防控。
Objective To analyze the drug resistance of patients with tuberculosis in early stage and retreatment of Handan City and provide reference for the clinical and control of tuberculosis. Methods A total of 348 sputum smear positive sputum smear positive pulmonary tuberculosis patients registered in Handan City from 2013 to 2013 were identified as positive. The drug resistance of Mycobacterium tuberculosis to isoniazid (H), rifampicin (R), streptomycin (S) and ethambutol (E) was detected by proportional method and analyzed for Mycobacterium tuberculosis The drug resistance status. Results 348 cases of Mycobacterium tuberculosis smear-positive pulmonary tuberculosis patients, the total drug resistance rate was 30.75%, MDR rate was 14.37%. The rates of resistance and multidrug resistance in retreatment group were higher than those in initial treatment group (χ2 = 67.41, χ2 = 52.11, P <0.01). The frequency of resistance to the four anti-TB drugs was H (42.53%), S (34.20%), R (27.59%) and E (20.98%) in descending order. The drug resistance rates of the four newly-treated groups to the four kinds of anti-tuberculosis drugs were lower than those of the second treatment group, with significant differences (P <0.01). Conclusions The prevalence of Mycobacterium tuberculosis in Tuberculosis patients in Handan City is high, so it is necessary to further strengthen the detection and control of drug-resistant tuberculosis.