耐多药肺结核病人耐药情况及临床治疗转归分析  

MULTIDRUG-RESISTANCE IN PATIENTS WITH PULMONARY TUBERCULOSIS:CLINICAL OUTCOME

作　　者：侯超[1] HOU Chao(Department of Public Health, Feixian People＇s Hospital, Feixian 273400, Chin)

机构地区：[1]费县人民医院公共卫生科,山东费县273400

出　　处：《青岛大学医学院学报》2016年第6期696-697,700,共3页Acta Academiae Medicinae Qingdao Universitatis

基　　金：国家自然科学基金资助项目(81172662)

摘　　要：目的了解耐多药肺结核（MDR-TB）病人的耐药及临床治疗转归情况,为促进其治疗和康复提供参考依据。方法选取我院2012—2014年收治的MDR-TB病人109例作为研究对象,其中初治MDR-TB病人58例（初治组）,复治MDR-TB病人51例（复治组）。收集并分析病人的耐药情况及治疗24个月后临床治疗转归情况,包括痰涂片转阴情况、病灶变化情况及治疗转归情况。结果初治组和复治组病人对二线药物耐药率比较,差异无显著性（P〉0.05）。治疗24个月后,初治组痰涂片转阴率、病灶吸收率及治愈率均明显高于复治组（χ2=6.312～10.871,P〈0.05）;而治疗24个月后,初治组治疗失败率明显低于复治组（χ2=15.109,P〈0.05）。结论初治组耐药情况与复治组无明显差异,而临床治疗的效果及其转归却明显好于复治组。Objective To understand drug resistance and clinical outcome in multidrug-resistant pulmonary tuberculosis patients （MDR-TB）, and provide reference basis for therapy and rehabilitation. Methods This study consisted of 109 MDR-TB patients treated in our hospital during 2012-2014 period, among them, 58 received initial treatment, and 51 received re treatment. Clinical data of drug resistance and clinical outcome, including negative sputum smear and changes of lesions after 24 months of treatment were collected and analyzed. Results The difference in drug resistance rate of second line drugs between the initial treatment group and the re-treatment group patients was not significant （P〉0.05）. After 24 months of treatment, sputum smear negative rate, lesion absorption rate and cure rate in patients of the initial treatment group were higher than that in those of the retreatment group （x^2 = 6.31 Z--10.871, P 〈 0.0 5）, and after 24 months, the failure rate of treatment in the initial treatment group was markedly lower than that in the re-treatment group （x^2 =15.109,P〈0.05）. Conclusion There is no significant difference in drug resistance between the initial treatment group and the re-treatment group, but the therapeutic effect and the sequelae in the former group is obviously better than that in the latter one.

关 键 词：广泛耐药结核 集落计数 微生物 治疗结果 

分 类 号：R521[医药卫生—内科学]