异烟肼和利福平治疗方案对单耐异烟肼或利福平肺结核患者的治疗效果  

Efficacy of isoniazid and rifampicin treatment regimens in patients with mono-isoniazid-resistant or rifampicin tuber-culosis

作　　者：谢剑敏 沈望 XIE Jianmin;SHEN Wang(Tongshan County People’s Hospital,Hubei Province,Tongshan County 437600,China)

机构地区：[1]湖北省通山县人民医院,437600

出　　处：《临床合理用药杂志》2021年第23期10-12,共3页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的观察异烟肼和利福平治疗方案对单耐异烟肼或利福平肺结核患者的临床疗效。方法选择2017年6月-2019年12月湖北省通山县人民医院收治的肺结核患者108例,根据其耐药情况分为敏感组、耐多药组和耐单药组各36例。所有患者均通过2HRZS/6HR方案给予抗结核治疗,比较各组患者初治肺结核、复治肺结核占比,比较初治肺结核和复治肺结核获得性耐多药情况,并比较各组肺结核病情发展情况。结果异烟肼、利福平耐药患者初治肺结核占比比较差异无统计学意义(x^(2)=0.031,P=0.860)。敏感组初治肺结核占比高于耐多药组(x^(2)=4.050,P=0.044)、耐单药组(x^(2)=5.600,P=0.018);耐多药组和耐单药组初治肺结核占比比较差异无统计学意义(x^(2)=0.148,P=0.700)。初治、复治肺结核患者中获得性耐多药肺结核占比比较差异无统计学意义(x^(2)=0.003,P=0.959)。治疗后,敏感组发展为耐多药肺结核的比例低于耐单药组,差异有统计学意义(x^(2)=8.862,P=0.003)。单耐异烟肼发展为耐多药肺结核占比高于单耐利福平,差异有统计学意义(x^(2)=8.100,P=0.004)。结论单耐异烟肼、利福平患者中多数为复治肺结核,选择异烟肼和利福平治疗方案时,极易导致患者病情发展为耐多药肺结核,因此,临床治疗应重视对患者的耐药性检测,根据检测结果选择相应的治疗策略,从而保证治疗效果,促进患者康复。Objective To observe the clinical efficacy of isoniazid and rifampicin therapy for mono-isoniazid-resistant or rifampicin tuberculosis patients. Methods 108 cases of tuberculosis patients admitted to Tongshan County People’s Hospital of Hubei Province from June 2017 to December 2019 were selected. According to their drug resistance,they were divided into sensitive group,multi-drug resistance group and single-drug resistance group,36 cases in each group. All patients were treated with 2 HRZS/6 HR antituberculosis therapy,the proportion of newly treated and retreated tuberculosis in each group was compared,the acquired multidrug resistance of newly treated and retreated tuberculosis was compared,and the development of tuberculosis disease in each group was compared. Results There was no significant difference in the proportion of newly treated pulmonary tuberculosis in isoniazid and rifampicin resistant patients( χ2= 0. 031,P = 0. 860). The proportion of newly treated pulmonary tuberculosis in the sensitive group was higher than that in the multi-drug resistance group( χ2= 4. 050,P =0. 044) and the single-drug resistance group( χ2= 5. 600,P = 0. 018). There was no significant difference in the proportion of newly treated pulmonary tuberculosis between the multi-drug resistance group and the single-drug resistance group( χ2=0. 148,P = 0. 700). There was no significant difference in the proportion of acquired multi-drug-resistant tuberculosis in newly treated and retreated tuberculosis patients( χ2= 0. 003,P = 0. 959). After treatment,the rate of developing multi-drug-resistant tuberculosis of the sensitive group was lower than that in the single-drug resistance group,and the difference was statistically significant( χ2= 8. 862,P = 0. 003). The proportion of mono-isoniazid-resistant pulmonary tuberculosis was higher than mono-rifampicin,and the difference was statistically significant( χ2= 8. 100,P = 0. 004). Conclusion The majority of patients with mono-isoniazid and rifampicin were patients with retreatabl

关 键 词：耐异烟肼肺结核 耐利福平肺结核 异烟肼 利福平 

分 类 号：R521[医药卫生—内科学]