结核病耐药影响因素分析.docVIP

结核病耐药影响因素分析 　　[摘要] 目的 分析结核病患者的耐药状况，讨论应对计策，为耐药结核的治疗提供参考。 方法 对结核患者的临床分离株进行菌种鉴定，对鉴定为结核分枝杆菌的临床分离株进行药物敏感检测。采用绝对浓度法的间接法，药敏试验的药物采用临床治疗的常规药物。 结果 结核分枝杆菌的总耐药率为27.28%，异烟肼、利福平耐药状况最为突出，其耐药率分别为16.65%、14.24%。治疗方案合理、规则用药、治疗中断、患者的个人收入及既往治疗史是结核病患者耐药发生的影响因素。 结论 单一耐药的比例下降，但是耐药菌的发展趋势是多重耐药，这为临床上采用的以此二种药物为主的四联疗法构成了挑战。 　　[关键词] 结核病；耐药状况； 结核分枝杆菌 　　[中图分类号] R52 [文献标识码] B [文章编号] 1673-9701（2012）30-0123-02 　　Analysis of drug resistance in tuberculosis patients 　　LE Haiying1 CHENG Xiaoxing2 　　1.The Outpatient Department on TB， Yinzhou Peoples Hospital of Ningbo City in Zhejiang Province， Yinzhou 315040， China； 2.The Tuberculosis Institute of 309 Hospital of PLA， Beijing 100091， China 　　[Abstract] Objective To analyze patients with tuberculosis resistance situation and discuss strategies in order to provide the reference for the treatment of drug-resistant TB. Methods We identified the clinical separation plant species of the tuberculosis patients and used the clinical drug sensitive detection with absolutely concentration for the separation plant identified as mycobacterium tuberculosis. The drug which we used in susceptibility test were conventional drugs. Results The total resistance of mycobacterium tuberculosis was 27.28%， the resistance of isoniazid、rifabutin were the most outstanding and the resistance were 16.65%， 14.24% respectively. Reasonable treatment options， rules， medication， treatment interruption， personal income and prior treatment history of patients were the influencing factors with TB drug resistance. Conclusion The single drug resistance ratio drops， but drug-resistant bacteria is multiple resistance， this situation pose is great challenges for clinical used with two kinds of drug primarily quad therapy. 　　[Key words] Tuberculosis； Drug-resistant condition； Mycobacterium tuberculosis. 　　我国是世界上结核病流行最严重的地区之一，此病也是重点控制的传染病。结核分枝杆菌复合群是引发结核病的罪魁祸首，人类的结核病主要是由结核分枝杆菌引起的。近年来耐药结核病状况不容乐观，这无疑加剧了结核病的严重态势。国家卫生部早在2007年就着手开展了全国结核病的耐药性基线调查。对结核病耐药性的调查可以对引起耐药的影响因素进行评估，掌控国内各地区结核病流行株的特征及其生物学的特征，以实现