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目的及时掌握我国各个省份的结核病药物耐药性水平,并且作到国际可比。方法采用 WHO 推荐的《结核病药物耐药性监测指南》规定的统一方法进行监测设计和操作。根据各省前一年的涂片阳性的病例数,计算出应监测的病例数,采用随机抽样的方法,在各省选择30个监测点(广东为40个监测点),将监测病例平均分配到各个监测点。每个监测点连续选取涂片阳性的病例,收集痰标本,进行分枝杆菌培养及利福平(RFP 或 R)、异烟肼(INH 或 H)、链霉素(SM 或 S)和乙胺丁醇(EMB 或 E)4种药物的药物敏感性实验。结果河南、山东、浙江、广东、湖北、辽宁、河南省第二轮监测以及内蒙古自治区的初始耐药率分别是:35.0%(226/646)、17.6%(178/1009)、14.8%(120/809)、18.6%(267/1432)、17.5%(150/859)、42.1%(344/818)、29.8%(364/1222)和35.7%(313/876);获得性耐药率分别为:66.O%(479/726)、50.O%(110/220)、59.3%(86/145)、33.7%(56/166)、44.5%(106/238)、55.8%(48/86)、60.8%(161/265)和65.3%(252/386)。结论从开展耐药性监测的各省耐药监测结果看,我国的耐药状况仍处于很高的水平。应当引起我们的高度重视,采取有力措施,加强结核病控制工作,控制耐药结核病,减少耐药菌株的蔓延。
Objective To grasp the level of drug resistance of tuberculosis in various provinces in a timely manner and make it internationally comparable. Methods The monitoring design and operation were carried out according to the uniform method stipulated by the WHO guidelines for monitoring drug resistance of tuberculosis. According to the number of smear-positive cases of the previous year in each province, the number of cases to be monitored was calculated. Using random sampling method, 30 monitoring points in each province (40 monitoring points in Guangdong) were selected, and the monitoring cases were equally distributed to each Monitoring points. Sputum samples were collected at each monitoring site for sputum samples, and mycobacterial cultures were incubated with either rifampicin (RFP or R), isoniazid (INH or H), streptomycin (SM or S) and B Drug sensitivity test of four drugs, amine-butanol (EMB or E). Results The initial resistance rates in the second round of surveillance in Henan, Shandong, Zhejiang, Guangdong, Hubei, Liaoning and Henan provinces and Inner Mongolia Autonomous Region were 35.0% (226/646), 17.6% (178/1009) and 14.8% / 809), 18.6% (267/1432), 17.5% (150/859), 42.1% (344/818), 29.8% (364/1222) and 35.7% (313/876) Were: 50% (479/726), 50.O% (110/220), 59.3% (86/145), 33.7% (56/166), 44.5% (106/238), 55.8% (48) /86)60.8% (161/265) and 65.3% (252/386). Conclusion From the monitoring results of drug resistance surveillance in various provinces, the drug resistance in China is still at a very high level. We should attach great importance to our efforts to take effective measures to strengthen TB control, control drug-resistant TB and reduce the spread of drug-resistant strains.