53例肺结核患者规律治疗中痰菌转阳的临床分析

目的 分析肺结核患者规律治疗过程中痰菌转阳的原因。 方法 回顾性分析53例临床规律治疗过程中痰菌转阳病例。 结果53例病人中，菌阴转阳病例18 例：第2个月转阳的8例（44.4%），其中原始耐药3例（16.7%）；第3个月转阳的2例（11.1%）；第5个月转阳8例（44.4%）。菌阳病例35例：第3个月转阳的13例（37.1%）；第5个月转阳的12例（34.3%）；第6个月转阳的8例（22.9%），其中3例病灶恶化（7.7%），1例由于免疫疾病服用大量激素，且耐药；第8个月及以后转阳的2例（5.7%）。支气管结核、耐药、合并糖尿病、复治是肺结核痰涂片转阳的主要原因。 结论 结核病治疗中要加强痰菌观察，及时发现转阳病例。

Clinical analysis on sputum smear positive conversion in patients with pulmonary tuberculosis during regular treatment

Objective To analyse the causes related to sputum positive conversion in patients pulmonary tuberculosis during regular treatment. Methods The data of sputum positive conversion in 53 patients with pulmonary tuberculosis during regular treatment was analyzed retrospectively. Results Of 53 patients,18 patients had sputum positive conversion.8（44.4%） cases became sputum positive at the second month,which included 3（16.7%） cases with primary drug resistance.2（11.1%）cases and 8（44.4%）cases had sputum positive conversion at the third month and the fifth month respectively.In addition,there were 35 cases with smear and culture positive before treatment among 53 cases.13（37.1%）cases had sputum positive conversion in the third month,12（34.3%） cases in the fifth month,and 8（22.9%）cases,which 3（7.7%）cases were progressive and 1 case with drug resistant was given high dose hormone due to immulogocial disease,were in the sixth month.There were another 2（5.7%） cases sputum positive conversion at the eighth month.The major factors which affect sputum positive conversion in patients with endobronchial tuberculosis,drug resistance,diabetes mellitus and retreatment. Conclusions It should be emphasized on monitoring sputum bacteria and finding cases with sputum positive conversion timely durmg the chemotherapy of tuberculosis.