摘要
【目的】分析结核患者的耐药现状，探讨其防治方法。【方法】回顾性分析471例结核患者的临床资料，根据治疗方法分为初治组和复治组，比较两组耐药率。【结果】471例分支杆菌培养阳性的住院结核患者，其中非结核分枝杆菌占4％（19／471），结核分枝杆菌占96％（452／471）；耐药肺结核患者116例，总的耐药率25．6％（116／452）。初治组356例，耐药率17．1％（G1／356），其中单耐药率10．1％（36／356），耐多药率2．5％（9／356），多耐药率4．4％（16／356）；复治组96例，获得性耐药率57．2％（5s／96），其中单耐药率28．1％（27／96），耐多药率15．6％（15／96），多耐药率13．5％（13／96），两组耐药率、单耐药、耐多药、多耐药比较均有显著差异性（Pd0．01）。耐药前三位药物为异烟肼（INH）15．0％（68／452）、链霉素（SM）13．3％（60／452）、利福平（RFP）12．6％（57／452）。【结论】在现行的直接督导短程化疗策略下，加强对结核病的管理，减少不规则化疗，提高患者依从性，尽早药敏试验，根据药敏结果，个体化治疗，确保结核患者得到规范、有效的治疗，控制传染源。
[Objective]To analyze the current situation of drug resistance of patients with tuberculosis, and to explore the prevention and treatment method. [Methods]Clinical data of 471 patient with tuberculosis were analyzed retrospectively. According to treatment methods, all patients were divided into initial treatment group and retreatment group. Drug resistance was compared between two groups. [Results]Among 471 hospitalized patients with tuberculosis who had positive mycobaeterium culture, non-tuberculosis mycobacterium was 4% （19/471） and tuberculosis mycobacterium was 96G （452/471）. There were 116 patients with drug resistant tuberculosis. The overall drug resistant rate was 25.6% （116/452）. The initial treatment group included 356 patients, and the drug resistance was 17.1% （61/356） in which single drug resistance rate was 10.1% （36/ 356）, multidrug resistant rate was 2.5%（9/356） and the poly drug resistance rate was 4.4%（16/356）. The retreatment group included 96 patients, and the acquired drug resistance rate was 57.2% （55/96） in which the single drug resistance rate was 28. 1% （27/96）, muhidrug resistant rate was 15. 6% （15/96） and the poly drug resistance rate was 13. 5G （13/96）. There were significant differences in drug resistance rate, single drug resistance, muhidrug resistance and the poly-drug resistance between two groups（ P 〈0.01）. The first three drugs with resistance were isoniazid （ 15. 0 %, 68/452）, streptomycin （ 13. 3 %, 60/452） and rifampin （12.6%, 57/452）. [Conclusion]Under the present direct-supervised short-term chemotherapy strategy, the management of tuberculosis should be strengthened, and the irregular chemotherapy should be reduced, and the compliance of patients should be improved. Drug sensitivity test should be taken as early as possible. Ac- cording to the results of drug sensitivity, individualized treatment is given. Patients with tuberculosis should be ensured to receive the effective and standard treatment so as to con
出处
《医学临床研究》
CAS
2013年第9期1800-1802,共3页
Journal of Clinical Research
关键词
结核
微生物敏感性试验
Tuberculosis
Microbial Sensitivity Tests
