不同类型复治肺结核的耐药性分析  

Drug resistance on different types of relapsing pulmonary tuberculosis

作　　者：陈静[1] 张廷梅[1] 蔡翠[1] 王念[1] 彭燕清 

机构地区：[1]贵阳市肺科医院,贵州贵阳550003

出　　处：《现代预防医学》2014年第7期1339-1341,共3页Modern Preventive Medicine

摘　　要：目的探讨不同类型复治肺结核的耐药情况,为临床复治肺结核患者制定合理的化疗方案提供科学依据。方法收集贵阳市肺科医院2010年1月-2011年12月住院的复治肺结核患者进行结核分枝杆菌培养、菌种鉴定和药物敏感性检测(异烟肼(INH)、利福平(RFP)、乙胺丁醇(EMB)、链霉素(SM),氧氟沙星(OFX)、卡那霉素(KM))。结果复治肺结核患者中耐药共203例,其中初治失败组80例,耐药率39.41%,耐多药率25.86%,治愈后复发组37例,其耐药率18.23%,耐多药率19.83%,不规则治疗1个月以上组26例,其耐药率12.81%,耐多药率12.07%,多次治疗失败痰菌持续阳性组60例,耐药率29.56%;耐多药率42.24%。在耐多药病例中以初治失败和多次治疗失败痰菌持续阳性为主。结论不同类型复治肺结核因既往用药史不同,其耐药率及耐多药率各异,不同类型复治肺结核不能都用标准复治方案,对于不同类型复治肺结核患者必须结合患者既往用药史和药敏试验结果综合分析制定个体化方案,减少耐药和耐多药结核的发生。Objective To analyse drug resistance of different types of relapsing pulmonary tuberculosis （RPTB） and to provide reliable science data for optimal chemotherapy. Methods Mycobacterium tuberculosis clinical strains were isolated from RPTB in-patients of Guiyang Affiliated Pulmonary Hospital from January 2010 to December 2011. Drug susceptibility of INH, RFP, EMB, SM, OFX and KM was carried on these strains. Results There were 203 cases of RPTB. In 80 cases of failed primary treatment, drug resistance rate was 39.41%, multidrug resistance （MDR） rate was 25.86%; In 37 cases of relapse after cure group, drug resistance rate was 18.23% and MDR rate was 19.83%; In 26 cases of non-standard treatment for more than 1 month, drug resistance rate was 12.81% and MDR rate was 12.07%; In 60 cases of failure after several treatments, drug resistance rate was 29.56% and MDR rate was 42.24%. In cases of failed primary treatment, MDR strains were mainly resistant.MDR strains from patients of failure after several treatments were mainly resistant. Conclusion Drug resistance rate and MDR rate are different because of different past medical histories. Standard re-treatment regimen is not suitable in all relapse cases of tuberculosis. Past medical history and drug susceptibility should be considered in order to prevent drug resistance and MDR.

关 键 词：结核 肺 复治 类型 抗药性 

分 类 号：R183[医药卫生—流行病学]