西藏拉萨地区198株结核分枝杆菌耐药性分析

目的：了解拉萨地区结核分枝杆菌对抗结核药物的耐药情况,为临床合理用药提供参考依据。方法：采用WHO推荐的比例法对分离自西藏拉萨地区肺结核患者的198株结核分枝杆菌进行4种抗结核药物（RFP、INH、SM、LVX）的药物敏感性试验。结果：198株结核分枝杆菌中耐药菌株有125株,总耐药率为63.1%（125/198）,总耐多药率为29.8%（59/198）,初治耐药率为55.1%（64/116）,复治耐药率为75.4%（40/53）,初治耐多药率为20.7%（24/116）,复治耐多药率为56.7%（30/53）。对RFP、INH、SM、LVX的耐药率分别为36.3%（72/198）、41.9%（83/198）、41.4%（82/198）和7.0%（14/198）。结论：西藏拉萨地区临床结核分枝杆菌耐药情况较为严重,应加强临床结核分枝杆菌耐药性监测,指导临床用药以防控耐药菌的产生。

Analysis on the Drug Resistance of Mycobacterium Tuberculosis in Lhasa area,Tibet

The drug resistance of the 198 isolated strains（Mycobacterium Tuberculosis）to four anti-TB drugs（Rifampin, Isoniazid, Streptomycin, Levofloxacin） were tested by using ratio method recommended by WHO forthe understanding drug-resistance of Mycobacterium Tuberculosis in Lhasa and for providing a theoretical basisfor the clinical medication. 125 strains of total 198 strains of Mycobacterium Tuberculosis were found to be resis-tant to the drugs with total drug-resistance rate of 63.1% and 29.8% of drug resistant strains were multi-drug re-sistant. The drug-resistance rates for initial TB patients and retreatment TB patients were 55.1% and 75.4% re-spectively. The multi-drug resistant rate for initial TB patients was 20.7% and 56.7% for retreatment TB pa-tients. The resistant rates of Mycobacterium Tuberculosis to RFP, INH, SM, LVX were 36.3%, 41.9%, 41.4% and7.0% respectively. The drug-resistant situation of clinical Mycobacterium Tuberculosis is more serious in Lhasaarea. Therefore, the monitoring drug resistance of clinical Mycobacterium Tuberculosis should be strengthenedand clinical medicine should be advised for preventing and controlling the generation of drug-resistant strains.