某院97例痰阳复治肺结核患者的复治原因与对抗结核药物的耐药情况分析  

Analysis of Causes for Retreatment of 97 Patients with Retreated Pulmonary Tuberculosis(Positive in Sputum Examination)in a Hospital and Their Resistance to Anti-tuberculosis Drugs

作　　者：李先蕊 陈洁 彭江丽 LI Xian-rui;CHEN Jie;PENG Jiang-li(College of Pharmacy,Dali University,Dali 671003,Yunnan;Kunming Third People's Hospital,Kunming 650041)

机构地区：[1]大理大学药学院,云南大理671003 [2]昆明市第三人民医院,昆明650041

出　　处：《抗感染药学》2023年第3期304-307,共4页Anti-infection Pharmacy

摘　　要：目的:分析医院痰阳复治肺结核患者的复治原因与对抗结核药物的耐药情况,为临床该类患者的救治提供参考。方法:选取2019年1月—2021年12月昆明市第三人民医院结核科收治的97例痰阳复治肺结核患者作为研究对象,分析患者的复治原因和对常用抗结核药物的耐药特点。结果:97例痰阳复治肺结核患者对异烟肼和利福平的耐药率最高(其耐药率分别为67.01%和75.26%),而对卷曲霉素和阿米卡星的耐药率最低(其耐药率分别为12.37%和11.34%);97例痰阳复治肺结核患者中有78例存在耐药情况,其中耐药类型主要为耐多药结核病(44例,占56.41%),其次为广泛耐药结核病(18例,占23.08%)和单耐药结核病(13例,占16.67%);97例痰阳复治肺结核患者复治的原因主要为复发(63例,占64.95%),而其耐药类型主要为耐多药结核病(36例,占57.14%)。结论:医院痰阳复治肺结核患者的复治原因主要为复发,其耐药类型主要为耐多药结核病,说明当前肺结核患者的耐药形势较为严峻,临床应当进一步加强对患者的管理,督促患者规范治疗,以减少其复发。Objective:To investigate the causes for retreatment of patients with retreated pulmonary tuberculosis(positive in sputum examination)in the hospital and their resistance to anti-tuberculosis drugs,and provide reference for the clinical treatment of such patients.Methods:A total of 97 patients with retreated pulmonary tuberculosis(positive in sputum examination)admitted to the Department of Tuberculosis of Kunming Third People's Hospital from January 2019 to December 2021 were selected as the subjects,and the causes for retreatment and the characteristics of drug resistance to common anti-tuberculosis drugs were investigated.Results:Among the 97 patients with retreated pulmonary tuberculosis(positive in sputum examination),their drug resistance rates to isoniazid and rifampicin were the highest(67.01%and 75.26%,respectively),and their drug resistance rates to capreomycin and amikacin were the lowest(12.37%and 11.34%respectively);78 of the 97 patients with retreated pulmonary tuberculosis(positive in sputum examination)had the drug resistance.The main drug resistance type was multidrug-resistant tuberculosis(44 cases,56.41%),followed by extensively drug-resistant tuberculosis(18 cases,23.08%)and monodrug-resistant tuberculosis(13 cases,16.67%).The main cause for the retreatment of 97 patients with retreated pulmonary tuberculosis(positive in sputum examination)was relapse(63 cases,64.95%),and the main drug-resistant type was multidrug-resistant tuberculosis(36 cases,57.14%).Conclusion:The main cause for the retreatment of patients with retreated pulmonary tuberculosis(positive in sputum examination)is relapse,and the main drug-resistant type is multidrug-resistant tuberculosis,indicating that the drug resistance in pulmonary tuberculosis patients is still in a severe situation.Clinically,it is necessary to fur‐ther strengthen the management of patients,and urge them to receive standardized treatment to reduce the relapse.

关 键 词：复治肺结核 抗结核药物 耐药特点 

分 类 号：R915[医药卫生—微生物与生化药学] R969.3[医药卫生—药学]