摘要
目的对单耐异烟肼（H）及单耐利福平（R）肺结核患者采用不同方案治疗后发生耐多药结核病（MDR-TB）的情况进行分析，以指导临床合理用药。方法搜集2010年1月至2014年12月河南省濮阳市耐药监测项目发现的单耐H肺结核患者332例、单耐R肺结核患者114例为研究对象。随机（抽签法，单耐H、单耐R的患者分别随机分组）分为标准化疗方案组（采用初、复治标准化疗方案，简称“标化组”，共计222例）和含左氧氟沙星化疗方案组（依据药物敏感性试验结果采用含左氧氟沙星化疗方案，简称“左氧组”，共计224例）。观察两组患者治疗后发生MDR-TB的情况。采用SPSS20．0统计软件包进行统计分析，组间比较采用矿检验，P〈0．05为差异有统计学意义。结果标化组患者中MDR-TB发生率（11．7％，26／222）明显高于左氧组患者（4．9％，11／224）（x^2=6．779，P=0．009）。在初治患者中，标化组患者中MDR-TB发生率（4．4％，8／180）稍高于左氧组患者（2．2％，4／185），但两者比较差异无统计学意义（x^2=1．495，P=0．222）；在复治患者中，标化组患者中MDR-TB发生率（42．9％，18／42）高于左氧组患者（17．9％，7／39）（x^2=5．880，P=0．015）。单耐R的患者中，标化组患者中MDR-TB发生率（37．5％，21／56）明显高于左氧组患者（17．2%，10／58）（x^2=5．906，P=0．015）。复治单耐R患者中，标化组患者中MDR-TB发生率（56．5％，13／23）明显高于左氧组患者（27．3％，6／22）（x^2=3．493，P=0．047）。结论单耐H和单耐R的初治患者，采用标准化疗方案不增加MDRTB的发生率，单耐R较单耐H的肺结核患者容易发展为MDR-TB，尤其单耐R的复治肺结核患者更易发展为MDR-TB。
Objective To analyze the prevalence of multidrug resistant tuberculosis （MDR-TB） after treat ment with different regimens in patients with mono-resistance to isoniazid （H） and rifampicin （R）, in order to guide rational drug use in clinical settings. Methods From January 2010 to December 2014, 332 pulmonary tuberculosis patients with mono-resistance to H and 114 pulmonary patients with mono-resistance to R identified by the drug re- sistance surveillance project in Puyang City, He＇ nan Province were enrolled as the study subjects. The subjects were randomized （through simple randomization among patients with mono-resistance to H and R respectively） into standard chemotherapy group （a total of 222 cases on regimens according to the standardized chemotherapy for naive and retreated patients, referred to as ＂standard group＂）; and the levofloxacin chemotherapy group （a total of 224 cases on regimens based on the drug sensitivity test results, containing levofloxacin chemotherapy, referred to as ＂levofloxacin group＂）. The incidence of MDR-TB after treatment in both groups was observed. SPSS 20. 0 statistical software package was used for statistical analysis, and the group comparison was performed using x^2 = test. P〈0. 05 was considered statistically significant. Results The incidence of MDR-TB was 11.7%（26/222） in the standard group, and 4.9% （11/224） in the levofloxacin group and the difference was statistically significant （x^2 = 6. 779, P=0. 009）. Among the newly diagnosed patients, the incidence of MDR-TB was 4.4% （8/180） in the standard group and 2.2 % （4/185） in the levofloxaein group, with no significant difference between the two （x^2 = 1. 495, P=0. 222）. Among the retreated patients, the incidence of MDR-TB was 42.9% （18/42） in the standard group and 17.9%（7/39） in the levofloxacin group, with statistical difference （x^2 = 5. 880, P 0. 015）. Among the patients with mono resistance to R, the incidence of MDR-TB was 37.5% （21/56） in th
出处
《中国防痨杂志》
CAS
2018年第3期286-291,共6页
Chinese Journal of Antituberculosis
基金
河南省濮阳市科技计划项目（140625）
关键词
结核
肺
抗药性
药物疗法
联合
临床方案
治疗结果
数据说明
统计
Tuberculosis, pulmonary
Drug resistance
Drug therapy, combinatiom Clinical regimens
Treatment outcome
Data interpretation, statistics
