不同年龄复治肺结核患者结核分支杆菌耐药性的研究

目的分析不同年龄组复治肺结核患者结核分支杆菌的耐药情况，探讨当前结核病耐药性发展趋势。方法将691例痰结核分支杆菌培养阳性的复治肺结核患者分为青年组149例、中年组255例和老年组215例，采用绝对浓度法进行INH、SM、EMB和RFP等4种抗结核药物耐药性测定。结果青年组、中年组和老年组获得性耐药率分别为73．8％、58．4％和45、1％，中年组高于老年组（P〈0．01），青年组高于老年组（P〈0．001）；获得性耐多药率青年组、中年组和老年组分别为44.1％、31．4％和19．5％，青年组高于中年组（P〈0．01）和老年组（P〈0．001），中年组高于老年组（P〈0．005）；对RFP的获得性耐药率青年组和中年组均高于老年组（P〈0．001）。结论不同年龄组获得性耐药率差异较大，建议应重视不同年龄组复治肺结核患者耐药率的监测，为修订结核病控制规划提供依据。

Study on drug resistance of Mycobacterium tuberculosis of retreatment patients in different age

Objective To analyze the condition of Mycobacterium tuber-culosis drug resistance of retreatment patients in different age group,evaluating the present trending of drug resistance of tuberculosis.Methods We divided 619 retreatment cases whose sputum Mycobacteriun tuberculosis were cultivated positive into 3 groups,including youth group(149 cases),middle age group(255 cases)and old age group(215 cases).All of the Mycobacterium tuberculosis were tested for resistance to INH,SM,EMB and RFP by absolute concentration method.Results The rate of acquired drug resistance in youth group was 73.8%,in middle age group 58.4%,in old age group 45.1%.There was significant statistics between middle age group and old age group(P<0.005),youth group and old age group(P<0.001).The rate of acquired multi-drug resistance in youth group,middle age group and old group were 44.1%,31.4% and 19.5% respectively,the significance test showed that youth group were higher than middle group(P<0.01)and old age group(P<0.001),middle age group was higher than old age group(P<0.005).The acquired resistance rate to RFP showed that both youth group and middle age group were higher than old age grou(P<0.001).Conclusion There are difference in acquired drug resistance rate in different age group,we suggest that monitoring the rate of drug resistance of different age groups of re-treatment patients is very important,offering the foundation in revising the strategy of tuberculosis control.