浙江省5地市耐多药结核病防治策略效果评价

发布时间：2018-04-28 10:46

本文选题：耐多药结核病 + 防治策略　；参考：《中国公共卫生》2014年04期

【摘要】：目的评估浙江省5个试点地市耐多药结核病防治策略实施效果,为今后耐多药结核病预防控制提供依据。方法对浙江省杭州、湖州、绍兴、衢州与丽水5个地市共7 140例涂阳肺结核患者进行耐多药筛查,按照统一的技术方案对耐多药肺结核患者进行治疗与管理,运用描述性统计和单因素分析方法对试点地区登记的耐多药结核患者发现、治疗等监测数据进行分析。结果试点地区在评估时间段内共确诊耐多药结核病患者537例,351例患者进行了标准耐药治疗;患者6个月末培养转阴率为71.4%,完成疗程患者治愈率为71.0%;复治失败和初治失败肺结核患者药敏检出耐多药比例分别为67.4%与52.4%,而新涂阳患者检出比例为2.5%;患者未进行耐药治疗主要原因为原方案治疗有效26.2%、迁出或失访20.6%、缺乏有效治疗方案19.8%、治疗前死亡15.1%。结论浙江省耐多药肺结核防治模式取得了一定效果,但患者纳入治疗比例较低,中断治疗比例偏高,副反应与远期疗效观察等问题需进一步研究解决。
[Abstract]:Objective to evaluate the effect of MDR-TB prevention and control strategy in 5 pilot cities of Zhejiang Province, and to provide evidence for prevention and control of MDR-TB in the future. Methods A total of 7 140 smear positive pulmonary tuberculosis patients in Hangzhou, Huzhou, Shaoxing, Quzhou and Lishui of Zhejiang Province were screened for multidrug resistance. Descriptive statistics and single factor analysis were used to analyze the data of detection and treatment of MDR-TB patients registered in the pilot area. Results A total of 537 patients with MDR-TB in the pilot area were treated with standard drug resistance therapy. At the end of 6 months, the negative conversion rate was 71.4 and the cure rate was 71.0. The multidrug resistance was 67.4% and 52.4% in the patients with failed relapse and initial failure respectively, and 2.5% in the patients with new smear positive, and the patients were not treated with the new smear positive, and the rates of multidrug resistance were 67.4% and 52.4%, respectively, and the proportion of the patients with newly diagnosed smear positive was 2.5%. The main reasons for drug resistance therapy were that the original regimen was effective 26.2g, the former regimen was effective, the former regimen was effective, the former regimen was effective, the former regimen was effective, the former regimen was effective, the former regimen was effective, the former regimen was effective and the former treatment was effective. Conclusion the prevention and treatment model of multi-drug resistant pulmonary tuberculosis in Zhejiang Province has achieved some results, but the proportion of patients receiving treatment is low, the proportion of interrupted treatment is on the high side, and the problems of side effects and long-term curative effect observation need to be further studied and solved.
【作者单位】：浙江省疾病预防控制中心科研信息处;浙江省疾病预防控制中心结核病防制所;
【基金】：卫生部科学研究基金浙江省医药卫生重大科技计划项目(WKJ2008-2-018)
【分类号】：R521

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