218例涂阳肺结核吡嗪酰胺耐药情况分析

目的 了解肺结核患者对吡嗪酰胺的耐药情况，为临床结核病防治提供参考。 方法 采用WHO推荐的BACTEC MGIT-960系统法对218例涂阳肺结核进行吡嗪酰胺耐药性检测分析。 结果 218例涂阳肺结核中耐吡嗪酰胺39例，占17.9%。其中163例初治患者耐吡嗪酰胺23例，占14.1%，55例复治患者耐吡嗪酰胺16例，占29.1%； 91例耐多药(MDR)患者耐吡嗪酰胺36例，占39.6%，127例非MDR患者耐吡嗪酰胺3例，占2.4%。复治患者吡嗪酰胺耐药率明显高于初治患者(P＜0.05)，MDR患者吡嗪酰胺耐药率明显高于非MDR患者(P＜0.01)。 结论 MDR肺结核耐吡嗪酰胺率较高，应重视对复治涂阳肺结核，尤其是MDR肺结核的吡嗪酰胺耐药性检测，以便采用更合理有效的方案治疗MDR肺结核。

Analysis on Pyrazinamide Susceptibility Testing of 218 Mycobacterium tuberculosis isolates by BACTEC MGIT 960

To understand the information about pyrazinamide(PZA) susceptibility of patients with pulmonary tuberculosis, and provide some reference to TB control and treatment in clinic. Using BACTEC MIGIT 960 system to conduct susceptibility test of Mycobacterium tuberculosis isolates to PZA from 218 smear positive pulmonary tuberculosis patients. 39 cases were PZA resistant by the test, the total PZA resistance rate was 17.9%. 23 of 163 new cases with tuberculosis were PZA resistant, the rate of PZA resistance was 14.1%; 16 of 55 re-treatment were PZA resistant, the rate was 29.1%; 36 of 91MDR were PZA resistant, the rate was 39.6%. 3 of 127 non -MDR were PZA resistant, and the rate was 2.4%. The PZA resistant rate of re-treatment was clearly higher than the rate of new cases(P＜0.05). And the PZA resistant rate of MDR was obviously higher than that of non-MDR (P＜0.01). It should be attached more importance to the re-treatment patients, especially MDR to test PZA susceptibility, so that the reasonable and effective therapy could be selected for MDR-TB.