不同类型复治肺结核的耐药性分析

发布时间：2018-08-30 15:36

【摘要】：目的探讨不同类型复治肺结核的耐药情况,为临床复治肺结核患者制定合理的化疗方案提供科学依据。方法收集贵阳市肺科医院2010年1月-2011年12月住院的复治肺结核患者进行结核分枝杆菌培养、菌种鉴定和药物敏感性检测(异烟肼(INH)、利福平(RFP)、乙胺丁醇(EMB)、链霉素(SM),氧氟沙星(OFX)、卡那霉素(KM))。结果复治肺结核患者中耐药共203例,其中初治失败组80例,耐药率39.41%,耐多药率25.86%,治愈后复发组37例,其耐药率18.23%,耐多药率19.83%,不规则治疗1个月以上组26例,其耐药率12.81%,耐多药率12.07%,多次治疗失败痰菌持续阳性组60例,耐药率29.56%;耐多药率42.24%。在耐多药病例中以初治失败和多次治疗失败痰菌持续阳性为主。结论不同类型复治肺结核因既往用药史不同,其耐药率及耐多药率各异,不同类型复治肺结核不能都用标准复治方案,对于不同类型复治肺结核患者必须结合患者既往用药史和药敏试验结果综合分析制定个体化方案,减少耐药和耐多药结核的发生。
[Abstract]:Objective to investigate the drug resistance of different types of retreated pulmonary tuberculosis and to provide scientific basis for the establishment of rational chemotherapy regimen for patients with recurrent pulmonary tuberculosis. Methods Mycobacterium tuberculosis was collected from patients with recurrent pulmonary tuberculosis hospitalized in Guiyang Pulmonary Hospital from January 2010 to December 2011. Identification of bacteria and determination of drug sensitivity (isoniazid (INH), rifampicin (RFP), (RFP), ethambutanol (EMB), streptomycin (SM), ofloxacin (OFX), kanamycin (KM). Results there were 203 cases of drug resistance in patients with recurrent pulmonary tuberculosis, including 80 cases of failure group, 39.41% of drug resistance rate, 25.86% of multi-drug resistance rate, 37 cases of relapsing group after cure, 18.23% of drug resistance rate, 19.83% of multi-drug resistance rate and 26 cases of irregular treatment group for more than one month. The drug resistance rate was 12.81% and the multi-drug resistance rate was 12.07%. In the group of continuous positive sputum bacteria, the drug resistance rate was 29.56, and the multidrug resistance rate was 42.24%. In multi-drug resistant cases, the failure of initial treatment and repeated treatment failed sputum bacteria were mainly positive. Conclusion the rates of drug resistance and multidrug resistance of different types of pulmonary tuberculosis are different due to the different history of drug use, and different types of pulmonary tuberculosis can not be treated with standard regimen. In order to reduce the incidence of drug resistance and multidrug resistance tuberculosis patients with different types of relapsed pulmonary tuberculosis must make a comprehensive analysis of the past drug use history and drug sensitivity test results.
【作者单位】：贵阳市肺科医院;
【分类号】：R521;R446.5

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