东莞市478例肺结核患者原始耐药监测Surveillance of Primary Resistance in 478 Cases of Pulmonary Tuberculiosis
彭建梅,易来龙,胡春梅,李国周,刘元欢
PENG Jian-mei,YI Lai-long,HU Chun-mei,LI Guo-zhou,LIU Yuan-huan(Dongguan Chronical Hospital
摘要(Abstract)：
目的监测东莞市分枝杆菌原始耐药情况,制定科学的防治对策。方法采用WHO制定的结核分枝杆菌耐药监测方案开展东莞市结核分枝杆菌耐药监测,使用比例法对478例新发现无抗结核用药史的441例菌阳肺结核患者的耐药性进行测定。结果441例患者中,原始耐药者101例,总耐药率为22.9%.各药的原始耐药率分别为异烟肼(H):15.19%,利福平(R):10.43%,链霉素(S):12.93%,乙胺丁醇(E):5.22%;原始耐多药率分别为:HR7.94%,HRS4.08%,HRE3.63%,HRSE2.27%。结论本地区结核分枝杆菌原始耐药现状较严重,须进一步加强结核病控制规划。
Objective To understand the primary resistance of Mycobacterium tuberculosis in Dong Guan,and to make scientific prophylactic and treatment strategies.Method Drug resistance Surveillance(DRS) Was implemented in Dong Guan according to WHO/IUATLD Guidelines for Surverllance of Drug Resistance in Tuberculosis(1994),and proportional method was used to detect primary resistance in the 441 cases of 478 new cases with bacillus-positive pulmonary tuberculosis without history of anti-tuberculosis drug use.Result The101 cases of 441 sickness.is the primary drug resistance(PDR) cases. The primary drug resistance(PDR) rates were 15.19%,10.43%,12.93%,5.22% for H.R.S and E respectively.The primary multi-drug resistance(MDR) rates were 7.94%,4.08%,3.63%,and 2.27% for HR,HRS,HRE and HRSE,respectively.Conclusion The results show that the problem of primary resistance of Mycobacterium tuberculosis is serious in Dong Guan,and National TB control program should be further strengthened.
关键词(KeyWords)：
结核;药物耐受性;监测
mycobacterium;tuberculosis and drug resistance;surveillance
基金项目(Foundation): 东莞地区结核病耐药监测研究项目(东卫科2001-[42])
作者(Author):
彭建梅,易来龙,胡春梅,李国周,刘元欢
PENG Jian-mei,YI Lai-long,HU Chun-mei,LI Guo-zhou,LIU Yuan-huan(Dongguan Chronical Hospital
参考文献(References)：
- [1]中华人民共和国卫生部.1990年全国结核病流行病学抽样调查资料汇编[M].
- [2]Nunn p,Felten M.Surve illance of resistance to anti-tuber-cu losis drugs in develop ing countries[J].Tuberc Lung D is,1994,75:163-167.
- [3]袁慧,谢丽娟.抗结核药物引起的副作用604例临床分析[J].中国防痨杂志,2002,22:154-156.
- [4]方毅敏,陈志成,潘四珍.异烟肼利福平吡嗪酰胺对结核病患者肝功能的影响[J].实用医学杂志,1997,13(9):609-610.
- [5]郭英江,崔德健.抗结核药所致肝损害[J].中华结核和呼吸杂志,1998:21(5):308-309.
- [6]施鸿生,王苏民,刘宇红,等.结核病耐药监测述略[J].中华结核和呼吸杂志,2000,23(7):391.
- [7]王国斌,彭义利,张国龙,等.河南省WHO结核病耐药监测报告[J].中国防痨杂志,1999,21(4):167-168,185-190.
- [8]李群,王晓萌,何海波,等.WHO浙江省结核病耐药监测研究报告[J].中华结核和呼吸杂志,2000,23(12):718.
- [9]钟球,钱明,李建伟,等.广东省WHO结核病耐药监测研究[J].中国防痨杂志,2001,23:5-7.