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耐药性结核离我们远吗

2017-08-15 09:44:49   中国青年网

结核病有着悠久历史。早在古埃及法老的木乃伊骨骼上,医学工作者就发现了结核病侵袭的痕迹。1972年,我国考古工作者在湖南长沙马王堆发掘的西汉古墓里,在女尸肺组织中也找到了清晰的结核病灶。

许多文学作品中都有对结核病的描写。张侠说,19世纪英国诗人雪莱为挚友济慈写下的哀挽长诗,诗中“昏暗的灵堂、白色死亡的阴影、无形的腐败”形象地描述了患者脸色苍白、日渐消瘦的情形,因此结核被称为痨病或白色瘟疫。

在人类认识、征服结核病的路上,德国的细菌学家科赫做出了重要贡献。1882年,德国科学家罗伯特·科赫宣布发现了结核杆菌,他认为肺结核就是杆菌侵入肺脏后引起的一种具有强烈传染性的慢性消耗性疾病。科赫还认为:结核病患者含菌的痰液吐到了阴暗角落里,干燥后病菌可随灰尘漫天飞舞,被行人吸入肺里就会染上病,所以大家都不要随地吐痰。

■ 结核其实离你很近

人们所说的结核病主要指肺结核。张侠说,肺结核的临床表现为咳嗽、咯痰、咯血、胸痛、发热、乏力、食欲减退等局部或全身症状。该病90%以上是通过呼吸道传染的,病人通过咳嗽、打喷嚏、高声喧哗等使带菌液体喷出体外,健康人吸入后就会被感染。

如今,部分年轻人沉迷于网络、流连于网吧、长期熬夜,抵抗力下降也易感染结核;部分免疫缺陷的患者,如长期服用激素的患者、移植术后患者,还有糖尿病人群等均为结核感染的高危人群;故培养良好的生活习惯、加强自身保护有利于预防肺结核。

张侠说,随着经济的发展和营养卫生条件的改善,结核病发病率明显下降。尤其是1944年抗结核药物问世,结核病不再被视为一种绝症。但近二三十年来,随着耐药性结核杆菌的出现,带来了肺结核的散播和难以控制。就如同青霉素在1943年问世后给败血症等患者带来希望,但青霉素耐药性在随后的短短两年就出现了一样。

■ 耐药结核病越来越多

近年来南非和我国的研究显示,耐药结核病在人与人之间的传播越来越多。让我们来认识一下什么叫耐药结核病?

单耐药结核病:是指结核病患者感染的结核分枝杆菌体外药物敏感实验(DST)证实对1种一线抗结核药物耐药的结核病。

多耐药结核病:是指结核病患者感染的结核分枝杆菌体外DST证实对1种以上一线抗结核药物耐药(但不包括同时对异烟肼和利福平耐药)的结核病。

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