涂阳肺结核患者337例耐药情况分析

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337例涂阳肺结核患者的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 337例结核分枝杆菌感染的涂阳肺结核患者中,总耐药率30.56%,耐多药率14.84%。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（P〈0.01）。对4种抗结核药物的耐药频度由高到低依次为H（42.73%）、S（35.31%）、R（28.49%）、E（21.66%）。初治组对4种抗结核药物的耐药率较复治组低,差异有统计学意义（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。

Drug resistance analysis of 337 smear-positive tuberculosis patients

Objective To analyze the drug resistance of the initial treatment and retreatment pulmonary TB patients registered in Handan,provide the reference for clinical and control of tuberculosis. Methods Culture positive and identify strain for the sputums of 337 smear-positive tuberculosis patients registered in Handan during 2013,test the resistance of mycobacterium tuberculosis for anti-isoniazid（ H）,rifampicin（ R）,streptomycin（ S） and ethambutol（ E） with proportion methods,and analyze the drug resistance of mycobacterium tuberculosis. Results The total resistance rate was 30. 56%,the MDR rate was 14. 84% in 337 smear-positive tuberculosis patients infected with mycobacterium tuberculosis. The total resistance rate and the MDR rate in retreatment group was higher than that in initial treatment group（ P〈0. 01）. The drug resistance frequency of 4 kinds of anti-tuberculosis was respectively H（ 42. 73%）, S（ 35. 31%）, R（ 28. 49%）,E（ 21. 66%） in descending order. The resistance rate for 4 kinds of anti-TB drugs was lower in initial treatment group than that in retreatment group（ P〈0. 01）. Conclusions The incidence rate of resistant mycobacterium tuberculosis in tuberculosis patients in Handan was high,effective measures need to be taken for detection and prevention of drug-resistant TB.