耐多药肺结核患者发现和纳入治疗情况分析

摘要：目的　通过分析中国全球基金结核病项目地区耐多药肺结核患者发现和纳入治疗情况，为制定中国
耐多药肺结核防治模式提供参考资料和科学依据。方法　收集整理中国全球结核病项目月度报表，分析不
同登记分类涂阳肺结核患者中涂阳培阳率，耐多药肺结核检出率以及确诊耐多药肺结核患者的纳入比例。
结果　截至２０１２ 年１２ 月底合计筛查涂阳肺结核患者６４５２６ 例， 培养阳性５０５５６ 例， 涂阳培阳率为
７８．８％；开展药敏试验４９３９９例，确诊耐多药肺结核患者７１３９例，耐多药肺结核检出率为１４．５％；其中
复治失败、初治失败、复发、初治３月末阳性和新患者中检出的耐多药肺结核患者数分别为１４４３例、６０５
例、２２８４例、１０５例和１４９６例，耐多药肺结核检出率分别为５５．８％、３７．９％、２６．０％、２４．３％和４．８％；
确诊耐多药肺结核患者纳入治疗的比例为６４．８％。结论　高危人群应该作为耐多药肺结核筛查的重点人
群，应通过加强患者健康教育、保证药物不间断供应等多方面措施提高确诊患者纳入规范化治疗的比例。
关键词：耐多药；结核／肺；培养；药物敏感试验；治疗
中图分类号：Ｒ１８３．３　　文献标识码：Ａ　　文章编号：１００９ ６６３９ （２０１４）０６ ０５４６ ０４

Epidemiological analysis and treatment enrollment of cases with multidrug-resistant tuberculosis

Objective To analyze the epidemiological status and treatment enrollment of cases with multi-drug resistant tuberculosis（MDR-TB）in China,and to provide scientific evidence for disease prevention and control. Methods The monthly report of Global Funding Project was collected and analyzed for culture positive rate among cases with smear positive,as well as MDR-TB detection rate and treatment of cases. Results A total of 64 526 cases with smear positive were rescreened by the end of December 2012,and 50 556 cases were found still positive for culture with the positive rate of 78.8%.Among 49 399 cases received drug sensitivity test,14.5% were confirmed to be multi-drug resistant,and more than half（55.8%）of them were cases failed for retreatment,followed by those failed for initial treatment（37.9%）,with TB relapse（26%）,smear still positive 3months after initial treatment（24.3%）and newly diagnosed TB cases（4.8%）.64.8% of confirmed MDR-TB cases were enrolled for treatment. Conclusions Screening for MDR-TB should be strengthened among high risk TB cases.Health education and standardized treatment may decrease the percentage of MDR-TB cases.