2019-2022年耐多药肺结核患者结核分枝杆菌药物敏感性试验结果分析  

Analysis on the drug sensitivity test results of mycobacterium tuberculosis in multidrug resistant pulmonary tuberculosis patients from 2019 to 2022

作　　者：张宏[1] 冯治宇[1] 任会丽[1] 汪敏[1] 陈泽莹 吴迪 袁园[1] 黄显林 邝浩斌[1] ZHANG Hong;FENG Zhiyu;REN Huili;WANG Min;CHEN Zeying;WU Di;YUAN Yuan;HUANG Xianlin;KUANG Haobin(Guangzhou Chest Hospital(National Key Laboratory of Respiratory Diseases,Key Laboratory of Tuberculosis Research in Guangzhou,Section IV of Tuberculosis,Department of Tuberculosis,Institute of Prevention and Treatment on Tuberculosis in Guangzhou Medical University),Guangdong,Guangzhou 510095,China)

机构地区：[1]广州市胸科医院(呼吸疾病全国重点实验室、广州市结核病研究重点实验室肺结核科结核四区、广州医科大学结核病防治研究院),广东广州510095

出　　处：《中国医药科学》2025年第6期113-116,共4页China Medicine And Pharmacy

基　　金：中医药局面上科研项目(20191252);广州市胸科医院IIT项目(202304)。

摘　　要：目的 分析2019-2022年耐多药肺结核患者的结核分枝杆菌药物敏感性试验结果,为制订更加精准有效的耐多药肺结核治疗方案提供依据。方法 回顾性分析广州市胸科医院住院及门诊的567例耐多药结核病(MDR-TB)患者痰液标本的结核分枝杆菌药物敏感性试验结果,统计抗结核药物的耐药率和敏感率,比较2020—2021年药敏试验结果的变化趋势,并分析影像学特征、治疗史及合并症等因素与耐药性的关系。结果 莫西沙星与乙胺丁醇耐药率较高,分别为64.62%和49.38%,阿米卡星耐药率较低,为11.46%。环丝氨酸、乙硫异烟胺及对氨基水杨酸的耐药率分别为40.00%、32.31%和40.00%,链霉素耐药率为80.00%。2021年乙胺丁醇敏感率为52.06%显著高于2020年的42.44%。可疑危险因素与耐药性差异无统计学意义。结论 耐多药肺结核患者对阿米卡星耐药性较低,对莫西沙星和乙胺丁醇耐药性较高。乙胺丁醇敏感性可能随着时间恢复。Objective To analyze the drug sensitivity test results of mycobacterium tuberculosis in multidrug resistant pulmonary tuberculosis patients from 2019 to 2022,and to provide a basis for developing more accurate and effective treatment plans for multidrug resistant tuberculosis.Methods A retrospective analysis on mycobacterium tuberculosis was conducted on the drug sensitivity test results of sputum samples from 567 multiple drug resistant tuberculosis(MDR-TB)patients admitted and outpatient to Guangzhou Chest Hospital.The resistance and sensitivity rates of anti tuberculosis drugs were statistically analyzed,and the changing trends of drug sensitivity test results in 2020 and 2021 were compared.The correlation between imaging characteristics,treatment history,and comorbidities and drug resistance were also analyzed.Results The resistance rates of moxifloxacin and ethambutol were relatively high,at 64.62%and 49.38%,respectively,while the resistance rate of amikacin was relatively low,at 11.46%.The resistance rates to cycloserine,ethionine,and aminosalicylic acid were 40.00%,32.31%,and 40.00%,respectively,while the resistance rate to streptomycin was 80.00%.The sensitivity rate of ethambutol in 2021 was 52.06%,significantly higher than 42.44%in 2020.There was no statistically significant correlation between suspected risk factors and drug resistance.Conclusion Multidrug resistant tuberculosis patients have lower resistance to amikacin and higher resistance to moxifloxacin and ethambutol.Sensitivity to ethambutol may recover over time.

关 键 词：肺结核 耐多药 药物敏感性试验 危险因素 

分 类 号：R521[医药卫生—内科学]