衢州市耐多药肺结核防治项目患者发现和治疗情况分析

发布时间：2018-05-07 15:32

本文选题：肺结核 + 耐多药　；参考：《现代预防医学》2014年19期

【摘要】：目的分析衢州市全球基金耐多药肺结核防治项目患者发现和治疗情况,为MDR-TB防治提供参考。方法收集2010年3月-2013年7月衢州市结核病防治定点医院所登记的全球基金结核病项目基础资料、报表数据及病案信息等,进行分析总结。筛查新患者、初治失败、复发、复治失败共4类涂阳患者1 735例,其中经菌型鉴定Mtb感染1 527例。结果 1 527例Mtb感染者中新患者1 363例、初治失败12例、复发132例、复治失败20例,共确诊MDR-TB患者72例(4.7%,72/1 527),其中新患者、初治失败、复发及复治失败患者MDR-TB检出率分别为1.2%(16/1363)、41.7%(5/12)、29.5%(39/132)和60.0%(12/20)。接受耐多药方案治疗42例(58.3%,42/72);治疗至6个月末痰涂片阴转率80.0%(20/25),痰培养阴转率84.0%(21/25)。6例MDR-TB患者完成疗程,治愈率66.7%(4/6)。结论复治失败、初治失败、复发是发现MDR-TB患者的重点人群;大部分患者能够接受二线抗结核药物组成的标准化治疗方案,并获得理想的痰菌阴转率;高度重视预防和坚持规范治疗是控制MDR-TB疫情的关键。
[Abstract]:Objective to analyze the discovery and treatment of multidrug resistant pulmonary tuberculosis (MDR-TB) project in Quzhou Global Fund, and to provide reference for the prevention and treatment of MDR-TB. Methods from March 2010 to July 2013, the basic data, report data and medical record information of TB projects of Global Fund in Quzhou City were collected and analyzed and summarized. There were 1 735 cases of smear positive in 4 types of smear positive patients, including 1 527 cases of Mtb infection identified by bacteriotype. Results among the 1 527 cases of Mtb infection, 1 363 cases were new, 12 cases were primary failure, 132 cases were relapse, 20 cases were failure of relapse. 72 cases of confirmed MDR-TB were diagnosed as 4.2 / 1 527 cases. The detection rate of MDR-TB in new patients, patients with initial failure, relapse and failure of relapse was 1. 2% 1363 3. 7%, 29. 5% (39 / 132) and 60. 012% / 20% (P < 0. 05) respectively. At the end of 6 months, the sputum smear negative conversion rate was 80.020 / 25%, and the sputum culture negative conversion rate was 84.0% / 25.6%. The cure rate was 66.7% and 4 / 6%. Conclusion the failure of relapse, initial failure and recurrence are the key groups of patients with MDR-TB, and most of the patients can accept the standardized treatment scheme composed of second-line antituberculous drugs, and obtain the ideal sputum negative rate. High attention to prevention and adhere to standardized treatment is the key to control the MDR-TB epidemic.
【作者单位】：浙江省衢州市疾病预防控制中心;
【分类号】：R521

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