摘要
目的分析结核性毁损肺耐药情况及临床特征，为耐药肺结核的诊断与治疗提供依据。方法对2005年5月至2011年5月住院的结核性毁损肺患者115例的耐药分型、耐药的分布、病变部位情况、结核性毁损肺病程与耐药关系、耐药结核性毁损肺是否规律治疗情况、及肺内临床表现与耐药关系进行分析。并对结核性毁损肺耐药的60例患者，分为病程〉5年、1年〈病程≤5年和病程≤1年的3组，对病程与耐药情况进行进一步分析统计。应用SPSS13．0软件进行统计分析。结果115例结核性毁损肺中，耐药60例，非耐药55例。结核性毁损肺耐药率为52．2％。在60例耐药的结核性毁损肺中，单耐药3例，占5．0％；多耐药15例，占25．0％；耐多药（MDR-TB）29例，占48．3％；广泛耐药（XDR—TB）13例，占21．7％。单耐药、多耐药、耐多药、广泛耐药比较，耐多药易发生毁损肺，差异有统计学意义（χ^2=22．933，P〈0．001）。在60例耐药患者中，抗结核药物中最易发生耐药的是利福喷丁（Rft），占90．0％（54／60），其余依次为RFP（占86．7％，52，60）、INH（占71．7％，43160）、S（占68.3％，41／60）、Lfx（占53．3％，32／60）、丙硫异烟胺（Pto）（占40．0％，24/60），其中卷曲霉素（Cm）和Ofx耐药最低[占10．O％（6／60）和13.3％（8／60）]。60例耐药患者病程与耐药关系：病程≤1年与其他比较易发生耐药，病程〉5年（4例）、1年〈病程≤5年（14例）和病程≤1年（42例）。3组相比较差异有统计学意义（χ^2=38．800，P〈0．001），耐药肺结核可能在短时间内（1年内）发生毁损肺，治疗耐药肺结核的关键是第一年。结核性毁损肺耐药患者，不规律治疗易发生耐药规律治疗17例（28．3％），不规律治疗43例（71．7％），差异有统计学意义（χ^2=11．267，P〈0．05）。结论结核性毁损肺耐药�
Objective To analyze the drag-resistance status and clinical characteristics in 115 tuberculosis cases with collapsed lung and provide the evidence for diagnosis and treatment for drug-resistant tuberculosis. Methods 115 tuberculosis cases hospitalized with collapsed lung were enrolled from May 2005 to May 2011 and we analyzed the relationship between drug-resistance with types of drug-resistance, distribution, lesions status, duration, and relationship between drug-resistance with treatment of drug-resistant tuberculosis and lung lesions.And according to the duration of three types of longer than 5 years, shorter than or equal to 5 years, shorter than of equal to 1 year, 60 cases with drug-resistance tuberculosis collapsed lung were analyzed the relationship between duration and drug-resistance. Results Among 115 cases with collapsed lung, 60 （52.2%） cases were drug-resistant, 55 were not. Of the 60 cases with drug-resistant collapsed lung, 3 （5.0%） cases had single drug resistance, 15 （25.0%） cases had polydrug resistance, 29 （48.3%） had multidrug resistance （MDR） , 13 （21.7%） cases had extensively drug resistance （XDR） . Compared with the status of single drug-resistance, polydrug resistance, MDR and XDR, the cases with MDR were prone to develop collapsed lung （ χ^2=22.933, P〈0.001 ） . Of the 60 cases with drug-resistance, the rates of resistance to anti-tuberculosis drugs were Rifapentine （90.0%, 54/60） , Rifampin （86.7%, 52/60） , isoniazid （71.67%, 43/60） , streptomycin （68.3%, 41/60） , Levofloxacin （53.3%, 32/60） , Protionamide （40.0%, 24/60） , Ofloxacin （ 13.3%, 8/60） , capreomycin （ 10.0%, 6/60） , in which Rifapentine were highest and Ofloxacin and capreomycin were lower.Of the 60 cases with drug-resistance, cases with duration shorter or equal to 1 year were prone to develop drug-resistance, compared with the other two types of duration （ χ^ 2=38.800, P〈0.001 ） . Of the cases who showed drug-resistance collapsed lung, the rate of
出处
《结核病与胸部肿瘤》
2012年第3期197-200,共4页
Tuberculosis and Thoracic Tumor
关键词
结核
肺
肺疾病
结核
抗多种药物性
Tuberculosis, pulmonary
Lung diseases
Tuberculosis, multidrug-resistant
