浙江省江山市626例肺结核患者耐药情况分析

王伟华; 郑逸华; 林雪梅; 毛晓敏; 林彩侠

doi:10.19428/j.cnki.sjpm.2018.18924

浙江省江山市626例肺结核患者耐药情况分析

Drug resistance analysis on 626 cases of pulmonary tuberculosis in Jiangshan City, Zhejiang Province

摘要

摘要:
目的观察肺结核耐药情况，为临床制定化疗方案提供科学依据。
方法回顾性分析2011年1月至2015年7月于江山市医院就诊的肺结核患者资料病例，并对6种抗结核药物的耐药性进行测试。
结果本次研究共纳入有药敏结果的患者626例，其中初治584例，复治42例；165例患者耐药，总耐药率为26.4%，单耐药率为15.7%，多耐药率为5.3%，耐多药为5.4%。初治患者总耐药率为24.5%，单耐药率为15.9%，多耐药率为5.1%，耐多药为3.4%。复治患者的总耐药率为52.4%，单耐药率为11.9%，多耐药率为7.1%，耐多药率为33.3%。初治患者和复治患者耐药率分别是异烟肼(INH)13.7%、42.9%；利福平(RFP)4.3%、33.3%；乙胺丁醇(EMB)2.7%、7.1%；链霉素(SM)13.4%、33.3%；氧氟沙星6.2%、19.0%；卡那霉素(KM)2.9%、11.9%。
结论江山市肺结核复治患者的耐药率高，尤其是耐多药率高。初治患者对异烟肼、链霉素的耐药性较高，初、复治患者均对乙胺丁醇耐药率低。应根据本地区耐药性检测情况合理使用抗结核药物，提高疗效，并加强综合管理。

Abstract:
ObjectiveTo investigate the drug resistance of pulmonary tuberculosis and provide scientific basis for clinical formulation of chemotherapy regimens.
MethodsA retrospective analysis of cases of tuberculosis in hospitals in Jiangshan City from January 2011 to July 2015 was conducted to test the resistance of six anti-TB drugs.
ResultsA total of 626 patients with drug sensitivity were included in this study, of whom 584 were initially treated and 42 retreated; 165 were drug resistant; the total drug resistance rate was 26.4%, the monoresistance rate 15.7%, polyresistance rate 5.3% and multidrug resistance rate 5.4%.The total resistance rate in the newly diagnosed patients was 24.5%.The monoresistance rate was 15.9%, polyresistance rate 5.1%, and multidrug resistance rate 3.4%.The total drug resistance rate in retreated patients was 52.4%, monoresistance rate 11.9%, polyresistance rate 7.1%, and multidrug resistance rate 33.3%.The resistance rates of newly diagnosed patients and retreated patients were isoniazid (INH)13.7%, 42.9%;rifampicin (RFP) 4.3%, 33.3%;ethambutol (EMB) 2.7%, 7.1%;Strain (SM) 13.4%, 33.3%;Ofloxacin 6.2%, 19.0%;Kanamycin (KM) 2.9%, 11.9%.
ConclusionThe resistance rate in retreated pulmonary tuberculosis patients in Jiangshan is high, especially the multidrug resistance rate.The newly-treated patients has higher resistance to isoniazid and streptomycin, and the initially treated and retreated patients prove to have lower resistance to ethambutol.Rational use of anti-tuberculosis drugs should be based on the detection of drug resistance in the local region so as to improve efficacy and strengthen integrated managementoftuberculosis.

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