【摘要】 目的了解山西省长治市流动人口结核病状况及其流行趋势,为有效控制耐药结核病流行提供依据。方法收集2000-2009年采用改良罗氏培养基从流动人口与常住人口中临床确诊为结核病的病例常规采集各种标本,涂片抗酸染色、经改良罗氏培养基上培养,生化鉴定为结核分枝杆菌的菌株及其病例作为背景资料,采用绝对浓度法的间接法测定分离菌株对链霉素、异烟肼、利福平、对氨柳酸、卡那霉素、乙胺丁醇和丁胺卡那霉素等的药物敏感性,并将分离自流动人口与常住人口的菌株耐药性进行了比较。结果统计学分析采用SPSS13.0数据处理软件进行χ2检验,P<0.05为差异有统计学意义。结果 2000-2009年进行结核分枝杆菌耐药监测共2315株,耐药菌株1039株,总平均耐药率为44.88%(1 039/2 315),其中流动人口耐药率为49.26%(533/1 082),常住人口耐药率41.04%(506/1 233)。流动人口的结核分枝杆菌耐药率呈上升趋势,从41.17%(35/85)上升至61.11%(77/126),而常住人口的菌株耐药率总体上呈下降趋势,从46.20%(61/132)下降为38.50%(40/104)。总平均耐单药率为11.53%(267/2 315),其中流动人口耐单药率为14.42%(156/1 082),常住人口耐单药率为9.00%(111/1233)。总平均耐多药率为13.82%(320/2 315),其中流动人口耐多药率15.43%(167/1 082),常住人口耐多药率12.41%(153/1 233)。流动人口组的总耐药率、耐单药率和耐多药率均高于常住人口组,差异有统计学意义(χ2分别为15.75、16.56和4.43,P均<0.05)。结论长治市流动人口的结核耐药率显著高于本地区常住人口的结核耐药率,应根据流动人口的特点加强防治措施。更多还原

【Abstract】 The purpose of this research was to understand the situation and the prevalence tendency of drug resistance tuberculosis(TB) among migratory population in Changzhi,Shanxi Province,and to provide the basis for controlling drug-resistance tuberculosis effectively.All specimens for TB cases from migratory and resident population were collected conventionally,and conducted by smearing and anti-fast stain.Then they were proceeded with culturing in the modified Lowenstein-Jensen medium,and Mycobacterium tuberculosis(M.tuberculosis) was identified by biochemical differentiation with PNB/TCH media.Subsequently,drug susceptibility test(DST) was conducted on the clinical M.tuberculosis isolates to streptomycin(SM),isoniazid(INH),rifampicin(RFP),paraaminosalicylic acid(PAS),kanamycin(KM),ethambutol(EB) and amikacin(BBK).The statistics result was analysed by SPSS 13.0 and χ2 test was used for the difference comparison P<0.05.A total of 2 315 clinical M.tuberculosis isolates were tested,and 1 039 were resistant.The total average drug resistance rate was 44.88%(1 039/2 315),in which the average drug resistance rate of the strains from the migratory and resident population was 49.26%(533/1 082) and 41.04%(506/1 233) respectively.The prevalence rate of drug resistance tuberculosis among migratory population increased from 41.17%(35/85)to 61.11%(77/126),while among resident population it decreased from 46.20%(61/132) to 38.50%(40/104).The average one-drug resistance rate was 11.53%(267/2 315),in whcih that from the migratory and resident population were 14.42%(156/1 082) and 9.00%(111/1 233) respectively.The average multi-drug resistance rate was 13.82%(320/2 315),in which that from the migratory and resident population was 15.43%(167/1 082) and 12.41%(153/1 233) respectively.It showed that the total drug resistance rate,one-drug resistance rate and multi-drug resistance rate in the migratory cases were much higher than those in the resident cases,and the difference was statistically significant(χ2 =15.75,16.56 and 4.43;P<0.05).It is very important to enhance TB control program,especially drug resistant TB program,for migratory population.更多还原