2017-2020年黑龙江省佳木斯市肺结核患者耐药情况分析

刘翠玉 历素萍 潘宝山 邢辉 梁博慧 荣天畅 张慧

刘翠玉, 历素萍, 潘宝山, 邢辉, 梁博慧, 荣天畅, 张慧. 2017-2020年黑龙江省佳木斯市肺结核患者耐药情况分析[J]. 疾病监测, 2021, 36(10): 1052-1056. doi: 10.3784/jbjc.202105130269
引用本文: 刘翠玉, 历素萍, 潘宝山, 邢辉, 梁博慧, 荣天畅, 张慧. 2017-2020年黑龙江省佳木斯市肺结核患者耐药情况分析[J]. 疾病监测, 2021, 36(10): 1052-1056. doi: 10.3784/jbjc.202105130269
Liu Cuiyu, Li Suping, Pan Baoshan, Xing Hui, Liang Bohui, Rong Tianchang, Zhang Hui. Drug resistance in pulmonary tuberculosis patients in Jiamusi, Heilongjiang, 2017–2020[J]. Disease Surveillance, 2021, 36(10): 1052-1056. doi: 10.3784/jbjc.202105130269
Citation: Liu Cuiyu, Li Suping, Pan Baoshan, Xing Hui, Liang Bohui, Rong Tianchang, Zhang Hui. Drug resistance in pulmonary tuberculosis patients in Jiamusi, Heilongjiang, 2017–2020[J]. Disease Surveillance, 2021, 36(10): 1052-1056. doi: 10.3784/jbjc.202105130269

2017-2020年黑龙江省佳木斯市肺结核患者耐药情况分析

doi: 10.3784/jbjc.202105130269
基金项目: 国家科技重大专项(No. 2017ZX10201302001)
详细信息
    作者简介:

    刘翠玉,女,黑龙江省七台河市人,硕士,主管临床检验师,主要从事结核分枝杆菌实验室检测工作,Email:1147401052@qq.com

    通讯作者:

    张慧,Tel:010–58900514,Email:zhanghui@chinacdc.cn

  • 中图分类号: R211; R521

Drug resistance in pulmonary tuberculosis patients in Jiamusi, Heilongjiang, 2017–2020

Funds: This study was supported by the the National Technology and Science Major Projects (No. 2017ZX10201302001)
More Information
  • 摘要:   目的   了解黑龙江省佳木斯市肺结核患者的耐药情况,为结核病疫情防控提供可靠的参考依据。   方法   收集2017 — 2020年黑龙江省佳木斯市结核病参比实验室接收的575例分枝杆菌培养阳性患者菌株进行菌种鉴定,采用固体比例法进行药物敏感度测试,分析异烟肼、利福平、乙胺丁醇、链霉素、氧氟沙星、卡那霉素的药敏试验结果。   结果   总耐药率为35.29%(198/561),初治患者总耐药率为32.35%(143/442),复治患者总耐药率为46.22%(55/119),两者间差异有统计学意义(χ2=7.893,P=0.005);总耐多药率为10.16%(57/561),初治患者耐多药率为7.92%(35/442),复治患者耐多药率为18.49%(22/119),两者间差异有统计学意义(χ2=11.473,P=0.01)。 结核分枝杆菌菌株耐药率顺位分别是链霉素(22.82%,128/561)、异烟肼(19.25%,108/561)、利福平(15.69%,88/561)、氧氟沙星(6.77%,38/561)、乙胺丁醇(6.6%,37/561)、卡那霉素(2.14%,12/561)。   结论   2017 — 2020年佳木斯市肺结核病耐药情况较严重,特别是利福平耐药患者的比例较高,应尽早发现耐药结核病患者并进行针对性规范化治疗管理,避免耐药结核病的传播。
  • 图  1  561例痰培养阳性肺结核患者基本情况

    Figure  1.  Basic information of 561 sputum culture-positive pulmonary TB patients

    表  1  肺结核患者6种抗结核药物的耐药顺位

    Table  1.   Drug resistance rank of 6 anti-TB drugs in pulmonary TB patients

     耐任一药物
    初治(442例)复治(119例)合计(561例)
    耐药数(例)耐药率(%)耐药数(例)耐药率(%)耐药数(例)耐药率(%)
    耐异烟肼7216.293630.2510819.25
    耐利福平5311.993529.418815.69
    耐乙胺丁醇214.751613.45376.60
    耐链霉素9020.363831.9312822.82
    耐氧氟沙星276.11119.24386.77
    耐卡那霉素71.5854.20122.14
      注:耐任一药物指经体外药物敏感试验证实结核分枝杆菌对指定的抗结核药物耐药,而不考虑对其他药物是否耐药
    下载: 导出CSV

    表  2  肺结核患者抗结核药物耐药类型

    Table  2.   Types of anti-TB drug resistance in pulmonary TB patients

      耐药类型
    初治(442例)复治(119例)合计(561例)χ2
    P
    耐药数
    (例)
    耐药率
    (%)
    耐药数
    (例)
    耐药率
    (%)
    耐药数
    (例)
    耐药率
    (%)
    单耐药7316.522218.499516.930.2590.611
     异烟肼163.6254.20213.74
     利福平92.0475.88162.85
     乙胺丁醇10.23010.18
     链霉素337.4797.56427.49
     氧氟沙星143.1710.84152.67
    多耐药276.1175.88346.060.080.927
     异烟肼+乙胺丁醇010.8410.18
     异烟肼+链霉素153.3943.36193.39
     利福平+链霉素61.3610.8471.25
     异烟肼+链霉素+乙胺丁醇20.4510.8430.53
     异烟肼+链霉素+氧氟沙星10.23010.18
     异烟肼+链霉素+卡那霉素10.23010.18
     利福平+链霉素+氧氟沙星10.23010.18
     链霉素+乙胺丁醇+卡那霉素10.23010.18
    耐多药357.922218.495710.1611.4730.010
     异烟肼+利福平71.5821.6891.60
     异烟肼+利福平+链霉素92.0465.04152.67
     异烟肼+利福平+乙胺丁醇30.68030.53
     异烟肼+利福平+氧氟沙星10.2310.8420.36
     异烟肼+利福平+乙胺丁醇+链霉素92.0443.36132.32
     异烟肼+利福平+链霉素+卡那霉素20.4521.6840.71
     异烟肼+利福平+链霉素+氧氟沙星10.2321.6830.53
     异烟肼+利福平+乙胺丁醇+氧氟沙星10.23010.18
     异烟肼+利福平+乙胺丁醇+链霉素+卡那霉素10.23010.18
     异烟肼+利福平+乙胺丁醇+链霉素+氧氟沙星10.2354.2061.07
    准广泛耐药71.58119.24183.210.0002a
     利福平+链霉素+氧氟沙星10.23010.18
     异烟肼+利福平+氧氟沙星10.2310.8420.36
     异烟肼+利福平+链霉素+氧氟沙星10.2321.6830.53
     异烟肼+利福平+乙胺丁醇+氧氟沙星10.23010.18
     异烟肼+利福平+乙胺丁醇+链霉素+氧氟沙星10.2354.2061.07
     异烟肼+利福平+乙胺丁醇+链霉素+氧氟沙
     星+卡那霉素
    20.4532.5250.89
      注:a. 由Fisher确切概率法计算;–. 无法计算
    下载: 导出CSV
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  • 收稿日期:  2021-05-13
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