综述
耐药结核病发病机制的研究进展
李勤静
焦伟伟
申阿东
作者及单位信息
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DOI: 10.3760/cma.j.issn.1001-0939.2015.09.016
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摘要

结核病是由MTB引起的传染性疾病,是全球仅次于艾滋病的第二大致死性感染性疾病。20世纪40年代以来随着抗结核药物的有效使用,结核病的发病率和死亡率曾一度大幅下降,但近年来由于耐药MTB的出现和广泛流行,结核病死灰复燃,给结核病的防控工作带来了严峻挑战。据世界卫生组织(WHO)估计,2013年全球报道的耐多药结核病(multidrug–resistant tuberculosis,MDR–TB)约30万例,其中9.0%的病例为广泛耐药结核病(extensively drug–resistant tuberculosis,XDR–TB),而全球MDR–TB的治愈率仅为48% [ 1 ] 。因此,耐药结核病,尤其是MDR–TB已成为目前结核病防控工作的重点和难点。

引用本文

李勤静,焦伟伟,申阿东. 耐药结核病发病机制的研究进展[J]. 中华结核和呼吸杂志,2015,38(9):691-694.

DOI:10.3760/cma.j.issn.1001-0939.2015.09.016

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结核病是由MTB引起的传染性疾病,是全球仅次于艾滋病的第二大致死性感染性疾病。20世纪40年代以来随着抗结核药物的有效使用,结核病的发病率和死亡率曾一度大幅下降,但近年来由于耐药MTB的出现和广泛流行,结核病死灰复燃,给结核病的防控工作带来了严峻挑战。据世界卫生组织(WHO)估计,2013年全球报道的耐多药结核病(multidrug–resistant tuberculosis,MDR–TB)约30万例,其中9.0%的病例为广泛耐药结核病(extensively drug–resistant tuberculosis,XDR–TB),而全球MDR–TB的治愈率仅为48% [ 1 ]。因此,耐药结核病,尤其是MDR–TB已成为目前结核病防控工作的重点和难点。
耐药结核病根据发病原因的不同将其分为原发性耐药结核病和获得性耐药结核病。传统的观点认为获得性耐药是MTB产生耐药性的主要形式,但近来的研究结果表明 [ 2 , 3 ],耐药结核病患者中存在较高比例的原发性耐药结核病患者,即由于直接感染耐药MTB而导致的耐药性结核病。因此,明确MTB耐药的产生和传播具有非常重要的意义,可为有效控制耐药结核病提供一定的思路。现主要从MTB耐药相关基因突变、耐药MTB的适应性改变和耐药MTB的富集繁殖等方面阐述耐药结核病的发病机制。
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备注信息
A
申阿东,Email: mocdef.labiamtoh61danehs
B
国家自然科学基金 (81271889)
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