2015-2017年度韶关市结核病就诊患者耐多药情况分析

目的  探析位于粤北山区的韶关市2015-2017年度耐多药肺结核患者（multi drug resistant pulmonary tuberculosis，MDR-TB）的筛查情况。 方法  回顾性分析562例可疑MDR-TB患者及新患者的临床资料，所有患者均接受了传统药敏试验，统计异烟肼（isonicotinyl hydrazide，INH）、利福平（rifampicin，RFP）、乙胺丁醇（Ethambutol，EMB）、链霉素（streptomycin，SM）、氧氟沙星（ofloxacin，Ofx）、卡那霉素（kanamycin，Km）耐药情况及MDR-TB筛查结果。 结果  传统药敏试验结果中，SM的耐药率最高，达19.22%（108/562），KM的耐药率最低，为4.45%（25/562）。562例患者的传统确诊结果显示，MDR-TB检出率为6.94%（39/562）。MDR-TB检出率在性别、年龄、文化程度、地区之间均无统计学意义（均有P>0.05）；不同患者类型的MDR-TB检出率之间有统计学意义（P < 0.001）。 结论  肺结核患者耐药率顺位依次为链霉素、异烟肼、利福平、乙胺丁醇、氧氟沙星和卡那霉素。复治组患者的单耐药率、耐多药率均高于初治组。应以复治患者为重点，扩大筛查范围，及时治愈初治患者。

Analysis of multi drug resistance status of tuberculosis patients in Shaoguan from 2015 to 2017

  Objective  To investigate the screening status of multi drug resistant pulmonary tuberculosis(MDR-TB) in 2015-2017.  Methods  The clinical data of 562 patients with suspected MDR-TB were retrospectively analyzed. All patients received traditional drug susceptibility tests. The data of isoniazid (INH), rifampicin (RFP), ethambutol (EMB), streptomycin (SM), ofxofloxacin (Ofx), kanamycin (Km) resistance and MDR-TB screening results were analyzed.  Results  Results of traditional drug susceptibility test showed that SM had the highest drug resistance rate[19.22% (108/562)] and KM had the lowest resistance rate[4.45% (25/562)]. Traditional diagnosis of 562 patients showed that the detection rate of MDR-TB was 6.94% (39/562). There was no statistically significant difference in the detection rate of MDR-TB between different sex, age, education level. The detection rate of MDR-TB was not statistically significant between different gender, age, education level and region (all P>0.05).There was significantly different in the detection rate of MDR-TB between different patient types (P < 0.001).  Conclusions  The drug resistance rate of pulmonary tuberculosis patients was followed by streptomycin, isoniazid, rifampicin, ethambutol, ofloxacin and kanamycin. The single drug resistance rate and multidrug resistance rate of the patients in the retreatment group were higher than those in the initial treatment group. With the focus on the retreatment of patients, expand the scope of screening, timely cure the initial treatment of patients.