摘要
目的分析湖北省全球基金耐多药结核病(MDR-TB)项目(以下简称"项目")阶段性实施结果,总结"项目"实施过程中的耐多药肺结核诊断、治疗和管理策略的成功经验与不足,提出改进措施,为湖北省下一步耐多药结核病控制工作提供科学依据。方法收集"项目"执行期间5个项目单位的月报表和季度报表,进行回顾性研究,使用SPSS 17.0软件对数据进行统计分析,率的比较采用χ2检验,P<0.05为差异有统计学意义。结果 2006年10月～2012年2月,共筛查培养耐多药肺结核可疑者5 176例,培养阳性率为87.06%。对培养阳性患者痰样本进行药敏试验4 233例,实验室确诊MDR-TB共873例,MDR-TB检出率为22.88%,不同登记分类的可疑者MDR-TB检出率差异有统计学意义(χ2=302.98,P<0.05)。确诊的873例MDR-TB中纳入治疗521例(纳入治疗率为73.07%),等待治疗160例,未纳入治疗192例。192例未纳入治疗患者中不能组成有效方案、治疗前死亡和拒治分别占30.73%、24.48%和23.44%。治疗满6月患者数315例,6月末痰涂片阴转率为72.70%,痰培养阴转率为67.62%。结论通过"项目"的实施,以地(市)为中心开展耐多药结核病治疗管理的模式、标准化治疗方案为主的治疗策略是可行的。耐多药结核病诊断治疗管理水平等方面有待进一步加强。
Objective To analyze and evaluate the effect of phased implementation of Global Found Multi-Drug Resistant Tuberculosis（MDR-TB） project in Hubei in order to share the experience on diagnosis,treatment and control of MDR-TB.Methods Data of monthly and quarterly reports from five cities were collected for retrospective analysis.SPSS17.0 was used for analysis.Results From October 2006 to February 2012,a total of 5176 MDR-TB suspects were screened with overall culture positive rate of 87.06%.4233 sputum samples were collected for drug susceptibility test（DST） and 873 were confirmed to be MDR-TB（22.88%）.The difference of MDR-TB positive rates were statistically significant among different registration categories of MDR-TB suspects（χ2=302.98,P〈0.05）.521 patients with MDR-TB were treated（73.07%）,160 were on the waiting list for treatment and 192 patients received no treatment because of no effective treatment regimen,died before treatment or refused for treatment which accounted for 30.73%,24.48% and 23.44% respectively.315 patients had been treated for at least 6 months and 72.70% showed sputum smear negative conversion,67.62% showed culture negative conversion.Conclusions The analysis of phased implementation of this project proves that the model which takes prefectural level as MDR treatment center and uses the standard treatment regimen as the major strategy is feasible.
出处
《中国预防医学杂志》
CAS
2012年第10期755-758,共4页
Chinese Preventive Medicine
关键词
结核病
耐多药
预防和控制
Tuberculosis
Multidrug-resistance
Prevention and control
