2016－2020年湖北省荆州市利福平耐药肺结核患者筛查及纳入治疗情况

李莹莹; 张宇; 杨尚鹏; 程春平; 曾玮

doi:10.3784/jbjc.202205200236

2016－2020年湖北省荆州市利福平耐药肺结核患者筛查及纳入治疗情况

Screening and treatment of rifampicin-resistant pulmonary tuberculosis patients in Jingzhou, Hubei, 2016−2020

摘要

摘要:
目的通过对“十三五”期间湖北省荆州市利福平耐药肺结核患者的筛查、发现及纳入治疗情况的分析，进一步探索适合荆州市的利福平耐药结核病控制策略和措施。
方法通过《结核病信息监测系统》收集2016—2020年荆州市相关监测数据。采用筛查率、检出率、纳入治疗率等指标，评价分析荆州市利福平耐药结核病患者发现及治疗情况。
结果 2016—2020年荆州市共登记病原学阳性肺结核患者7 273例，开展耐药筛查3 885例，检出利福平耐药患者380例。病原学阳性肺结核患者利福平耐药筛查率为53.42%，呈逐年上升趋势（趋势χ²=3 558.431，P＜0.001）；筛查病原学阳性患者中利福平耐药检出率为9.78%，复治患者检出率（30.58%）明显高于初治患者检出率（5.85%）（χ²=360.348，P＜0.05），利福平耐药检出率呈逐年下降趋势（趋势χ²=263.254，P＜0.001），各县（市、区）利福平耐药检出率差异有统计学意义（χ²=22.865，P＜0.05），其中监利市（13.15%）和松滋市（12.43%）检出率较高；2016—2020年荆州市确诊的利福平耐药结核病患者纳入治疗率为78.95%，呈上升趋势（趋势χ²=16.657，P=0.002）。
结论 “十三五”期间荆州市利福平耐药肺结核患者筛查率及纳入治疗率均升高，检出率下降，耐药结核病防治工作取得了一定的成效。 “十四五”期间应进一步争取政策支持，加强患者治疗管理和感染控制，减少耐药结核病的发生。

Abstract:
Objective To analyze the screening, detection and treatment of rifampicin-resistant pulmonary tuberculosis (TB) patients in Jingzhou, Hubei province, during 2016−2020, and explore the suitable rifampicin-resistant pulmonary TB control strategies and measures in Jingzhou.
Methods The drug resistant TB surveillance data in Jingzhou from 2016 to 2020 were collected through the “Tuberculosis Information Surveillance System”. The detection and treatment of rifampicin-resistant pulmonary TB patients in Jingzhou were evaluated and analyzed by screening rate, detection rate and treatment rate.
Results From 2016 to 2020, a total of 7 273 cases of etiological positive pulmonary TB cases were registered in Jingzhou, drug resistance screening were conducted for 3 885 cases, and 380 cases were rifampicin resistant. The screening rate of rifampicin resistance was 53.42% in the etiological positive pulmonary TB patients, which showed an increasing trend year by year (trend χ²=3 558.431, P<0.001). The detection rate of rifampicin resistance in pulmonary TB patients detected in drug resistance screening was 9.78%, and the detection rate of rifampicin resistance in retreatment patients (30.58%) was significantly higher than that in newly treated patients (5.85%) (χ²=360.348, P＜0.05), The detection rate of rifampicin resistance showed a decreasing trend year by year (trend χ²=263.254, P<0.001). The differences in the detection rate of rifampicin resistance were significant among counties (χ²=22.865, P<0.05), and the detection rates were higher in Jianli (13.15%) and Songzi (12.43%). From 2016 to 2020, the treatment rate of rifampicin resistant pulmonary TB patients diagnosed in Jingzhou was 78.95%, showing an upward trend (trend χ²=16.657, P=0.002).
Conclusion During 2016−2020, the screening rate and treatment rate of rifampicin resistant pulmonary TB patients in Jingzhou increased, and the detection rate of rifampicin resistance decreased. The prevention and control of drug-resistant TB has achieved certain results. During the next five years, we should further seek policy support, strengthen TB patient treatment management and infection control, and reduce the incidence of drug-resistant TB.

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