目的：分析评价重庆市主城区肺结核耐药情况，为下一步耐药防治工作提出建议。方法对主城区2009年9月至2010年6月期间新登记的涂阳肺结核患者进行问卷调查，同时开展患者痰培养、药敏试验等相关实验室检测，对结果进行分析。结果主城区涂阳肺结核患者总耐药率、耐多药率分别为27．62％、10．50％，初治、复治患者耐多药率分别为6．99％、23．68％；181例肺结核患者耐药率顺序为异烟肼（H ）为19．34％、链霉素（S ）为18．23％、利福平（R ）为13．26％、乙胺丁醇（E ）为11．05％、氧氟沙星（Ofx）为6．08％、卡那霉素（Km）为2．21％；50例耐药患者中，共计有20种结核病耐药谱型；男性、既往接受过抗结核治疗、咳嗽咳痰大于等于2周在耐药和非耐药肺结核患者间差异有统计学意义（P＜0．05）。结论重庆市主城区肺结核耐药疫情形势严峻，应将耐药监测工作日常化，同时关注可能产生耐药的相关因素。%Objective To analyse and evaluate the status of drug-resistant tuberculosis of urban area of Chongqing ,and to pro-vide advice for the work of drug-resistant tuberculosis .Methods The smear positive TB cases registered between September 2009 and June 2010 were administered to questionnaire survey .At the same time ,the relating testing ,such as the sputum culture testing and drug susceptibility testing ,etc were conducted ,then analysis .Results The drug resistance rate and multi-drug resistant rate of smear positive TB cases of urban area were 27 .62% and 10 .50% respectively .The multi-drug resistant rate of new cases and re-treatment cases were 27 .62% and 23 .68% .The sequence of the rates of resistance were as follows :isoniazid(19 .34% ) ,streptomy-cin(18 .23% ) ,rifampicin(13 .26% ) ,ethambutol(11 .05% ) ,ofloxacin(6 .085% ) ,kanamycin(2 .21% ) .There were 20 types of drug-resistant spectrum among the 50 drug-resistant TB cases .The difference of the male gender and TB treatment and cough more than 2 weeks between the drug-resistant cases and the non drug-resistant cases were statistically significant (P<0 .05) .Conclusion The epidemic situation of drug-resistant tuberculosis of urban area is severe ,and the work of resistance monitoring should be routine . The correlative resistance factor should be concerned .
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