结核分枝杆菌L型感染对结核病患者耐药状况的影响  

Effect of mycobacterium tuberculosis L form infection on drug resistant state in tuberculosis patients

作　　者：杨小猛 赵丹 陈倩瑜 秦道新 殷玲丽 杜丽伟 

机构地区：[1]深圳市罗湖区妇幼保健院,广东深圳518019 [2]深圳市罗湖区慢性病防治院,广东深圳518029

出　　处：《临床肺科杂志》2015年第3期426-429,共4页Journal of Clinical Pulmonary Medicine

基　　金：深圳市罗湖区科技计划项目(No 2009014)

摘　　要：目的分析深圳市罗湖辖区结核病患者分枝杆菌(Mycobacterium tuberculosis,MTB)及其L型(MTB-L)的耐药状况,探讨MTB-L感染对结核病患者耐药状况的影响。方法收集确诊的960例患者(初治916例,复治44例)痰液标本,对其中涂片染色阳性的468例标本进行培养,并对培养阳性的标本进行异烟肼、链霉素、利福平和乙胺丁醇等四种一线药物药敏试验,比较MTB和MTB-L耐药率的差异。结果 MTB-L和MTB对四种一线药物的单耐药率、多耐药率和耐多药率均不同;MTB-L初治始耐药率显著高于MTB初治始耐药率(46.7%vs 22.4%,P<0.05);MTB-L复治耐药率略高于MTB复治耐药率,但差异无统计学意义(46.7%vs 33.3%,P>0.05)。结论 MTB-L感染可能与结核病患者耐药状况改变和耐药率增高有关,加强MTB-L感染监测和耐药分析是当前结核病防控的重要策略之一。Objective To analyze the infection status of mycobacterium tuberculosis （MTB） and mycobacterium tuberculosis L form （MTB-L） in tuberculosis patients in Luohu district of Shenzhen and to investigate the effect of MTB-L infection on the resistant state in tuberculosis patients. Methods The sputum samples were collected from 960 definite tuberculosis patients （916 initial treatment and 44 re-treatment） and detected by acid-fast staining meth- od. 468 positive sample by smear staining method were cultivated, then the cultivated positive sample were carried out susceptibility test with INH, SM, RFP and EB. The statistical difference of the resistant rates of MTB and MTB- L were analyzed. Results The resistance rates of MTB and MTB-L against INH, SM, RFP and EB were obviously different. The resistance rate of initial treatment of MTB-L was sharply higher than that of MTB （46. 7% vs 22. 4% , P 〈 0. 05 ）. The resistance rate of re-treatment of MTB-L was slightly higher than that of MTB （46. 7% vs 33.3% , P 〉 0. 05 ）. Conclusion MTB-L infection might participate in the changed resistant state and heightened resistant rate in tuberculosis patients. MTB-L infection monitoring and resistance analysis are important strategies of current tuberculosis control.

关 键 词：结核分枝杆菌 结核分枝杆菌L型 药物敏感试验 

分 类 号：R52[医药卫生—内科学]