结核病人结核菌耐药性的动态观察

目的：分析和评价结核分枝杆菌的耐药动态，为今后的结防工作提供参考依据。方法：收集本所12年来门诊及阳肺结核病例的菌株做药敏试验。分4个阶段（1990至1992；1993至1995；1996至998；1999至2001年）进行耐药率分析。结果：初治耐药率分别为27.8％，22.1％和17.3％；初治耐多药率分别为2.5％，3.6％，6.5％和2.7％。复治耐药率分别为66.7％、71.7％、65.6％和58.2％；复治耐多药率分别为25.5％，31.3％，25％和24.6％。初治耐药率随年度阶段逐渐下降趋势；复治耐药率自1996年以来也有下降趋势，但复治耐药率及耐多药率远远高于初治耐药率及耐多药率。结论：控制耐药的关键是积极发现，规范治疗和治愈传染性肺结核，广泛实施DOTS，做好耐药监测评价工作。

DYNAMIC OBSERVATION OF DRUG RESISTANCE FOR TUBERCULOSIS.

Objective:To analyse and evaluate the trend of antituberculosis drugs resistance for tuberculosis and provide base for tuberculos is control Methods: To collect in-patient case in different years,ie.1990~1992,1993~1995,1996~1998, 1999~2001.The trend of drug resistance was analysed. Results:Th e prevalence o f primary drug resistance was 27 8%,22 7%,22 1% and 17 3% i n four periods,respectively.The prevalence of primary MDR-TB drug resistance was 2 5 %,3 6%,6 5% and 2 7%,respectively.The prevalence of acquired drug resistance was 66 7%,71 7% ,65 5 % and 58 2%,respectively.The prevalence of acquired MDR-TB drug resistance was 25 5%,31 3%,25% and 24 6%,respectively.The prevalence of primary drug resistanc e was decreasing and the prevalence of acquire MDR-TB drug resistance was decreasing since 1996 as well.Conclusion:The key of cortrolling drug re sistance is to diagnose early,take corresponding measure,prevent the spread of pulmonary tuberculo sis,implement DOTS and improve the evaluation work of drug resistance.