标准化疗方案治疗失败肺结核患者原因分析

目的分析标准化疗方案治疗肺结核患者失败与耐药及其它相关因素的关系,探究标准化疗方案治疗失败的原因,为我国结核病控制以及耐药结核病控制提供参考。方法收集新发涂阳肺结核患者相关信息;纳入肺结核患者在治疗0、5月末收集痰标本进行痰涂片检查和分离培养,采用比例法进行药物敏感性测定,获得治愈和失败两组患者的耐药信息。结果男性患者的失败率低于女性患者(P0.01)、年龄40~60岁、待业人员的患者失败率高于其它年龄职业患者(P0.01),复治病例首次治疗持续时间≥8个月的失败率最高(26.50%)(P0.01),治疗中出现漏服药患者的失败率高于规律用药者(P0.01);治愈组登记时的单一耐药率、多耐药率、耐多药率均低于失败组(P0.01)。结论女性、40~60岁、待业、复治病例首次治疗持续时间≥8个月、治疗中出现漏服药等是影响治疗失败的相关危险性因素;标准化疗方案治疗失败主要是由于肺结核患者对抗结核药物耐药特别是耐多药所致。

Analysis of the Reasons for Failure of Pulmonary Tuberculosis Patients with Standard Chemotherapy Regimen

Objective To analyze the relationship between the failure of treatment pulmonary tuberculosis and drug resistance and other relative factors,and explore the reasons of failure of treatment pulmonary tuberculosis,to provide reference for tuberculosis and drug-resistant tuberculosis control.Method Collecting the related information of new pulmonary tuberculosis patients with smear-positive,sputum were collected from patient＇s treatment at the first and fifth month,samples were token sputum smears and Isolation culture test,drug sensitivity was tested by proportion method.Results Male failure rate is lower than female（P0.01）.The failure rate of job-waiting persons and aged 40～60 are above others（P0.01）.The highest failure rate is re-treatment patients who treated for more than 8 months at the first time（26.50%）（P0.01）.Failure rate for missing drug-taking patient is above the regular drug taking（P0.01）.Single drug resistance,two drug resistance,multidrug resistance in treatment groups are lower than failure groups（P0.01）.Conclusions Females,aged 40～60,job-waiting,re-treatment for more than 8 months and missing drug-taking were the relative risk factors of failure.Standard chemotherapy regimen failure was due to drug resistance,especially the multidrug resistance.