Email Alert | RSS    帮助

中国防痨杂志 ›› 2008, Vol. 30 ›› Issue (5): 395-398.

• 论著 • 上一篇    下一篇

黑龙江省WHO结核病耐药监测报告

谢艳光;李发斌;闫兴录   

  1. 黑龙江省结核病防治所 哈尔滨 150030
  • 出版日期:2008-05-10 发布日期:2011-11-03

WHO TB drug resistant survey in Heilongjiang province

Xie Yanguang, Li Fabin, Yan Xinglu   

  1. Heilongjiang Provincial Institute for TB Control and Prevention,Harbin 150030, China
  • Online:2008-05-10 Published:2011-11-03

摘要: 目的 掌握黑龙江省结核病细菌学耐药水平,评价结核病控制质量和效果,为制定全省结核病防治规划提供依据。方法 采用分层整群抽样,选取30个县(区)作为监测点,每个监测点痰涂片抗酸染色检查为阳性的病人均为入选病例,初治涂阳病人入选56例。采用比例法对INH、SM、RFP、EMB进行药物敏感性试验。结果 2004年耐药监测期间总纳入病例2144例,其中,痰培养污染率2.1%、涂阳培阴率3.8%,进行药敏试验人数2019例,供药敏分析1995例,初治病人占78.9%、复治病人占21.1%。初始耐药率为36.2%,获得性耐药率为67.7%,初始MDR耐药率为7.2%,获得性MDR耐药率为30.4%。结论 黑龙江省结核病耐药水平是已知开展耐药监测省份中高耐药省份之一,对黑龙江省结核病控制工作带来严重挑战。提示黑龙江省要一方面进一步提高全省DOTS的实施质量,通过做好基本DOTS来逐步减少耐药结核病人的产生;另一方面要积极争取解决现有耐药结核病人的治疗问题,最大限度地减少耐药结核病例,如期实现结防规划目标。

关键词: 结核, 耐药, 监测, 黑龙江省

Abstract: Objective To understand the status of drug resistant in M. tuberculosis in Heilongjiang province, to evaluate the quality and effectiveness of TB control and provide evidence for TB control policy development in Heilongjiang province. Methods According to the Guidelines for Surveillance of Drug Resistance in Tuberculosis of WHO/IUATLD, sampling method of layered group, thirty counties/districts were selected as surveillance sites. All smear positive cases on each surveillance site were included in the surveillance, 56 new smear positive cases were selected. Proportion method was used to conduct DST of INH, SM, RFP, EMB. Results 2 144 cases were included in the period in surveillance of drug resistance in 2004, among which the culture pollution rate was 2.1%, the culture negative rate was 3.8%. 2 019 cases had DST, among which the Results of 1 995 cases were analyzed. 78.9% was new cases and 21.10% was re-treatment cases. The proportion of primary drug resistant was 36.2%, the proportion of acquired drug resistant was 67.7%, the proportion of primary MDR was 7.2% and the proportion of acquired MDR was 30.4%. Conclusion Heilongjiang province is one of the higher drug resistant provinces where the surveillance of drug resistance has carried out. The high level of drug resistance was a big challenge in the work of tuberculosis control in Heilongjiang province. This suggested that on one hand the quality of DOTS should be improved in all of province, drug resistance cases would be reduced gradually through carrying out basic DOTS; on the other hand, the supports came from all levels of government and foreign aid project should be actively strived to solve the problem of the existing drug-resistant tuberculosis treatment, to reduce the drug resistance cases in farthest and achieve the goal of Tuberculosis Control Program on time.

Key words: tuberculosis, drug resistance, survey, Heilongjiang province