耐药肺结核病人的临床化疗效果及影响因素调查

目的 评价结核病耐药以后对肺结核统一化学治疗方案效果的影响,为结核病控制规划策略调整提供参考。方法 通过回顾性调查方式收集2012—2013年间治疗管理的227例肺结核病人,依据抗结核药物敏感试验结果将其分为耐药组（95例）及敏感组（132例）,对其治疗效果及影响因素进行比较分析。结果 通过调查发现结核菌耐药组疗程结束后痰标本中结核分枝杆菌阴转率为74.7%、抗结核药物敏感组痰中结核菌阴转率为91.7%,其病人细菌学复发率分别为11.3%及3.31%。然后耐一种药者痰菌阴转率为87.0%;耐两种药及三种药者分别为71.4%和54.5%。结论 肺结核病患者原发耐药,尤其是同时对多种抗结核药物耐药是导致化学药物治疗失败的重要原因,临床用药时应认真参考药敏试验结果进行合理判断,慎重选择。

Research on Effect of Chemotherapy and Influence Factors to Drug Resistance of Mycobacterium Tuberculosis

Objective To investigate the effect of Chemotherapy and Influence Factors to Drug Resistance of Mycobacterium Tuberculosis.Methods 227 sputum positive tuberculosis were divided into two groups：drug resistant group（95cases） and drug-sensitive group（132 cases） in two years from January 2012 to December 2013,which had been compared.Results The sputum culture conversion rate was 74.7% at the bottom of the second month,the rate of the end of treatment was 91.7%.The bacteriological relapse rate of converted cases in follow-up was 11.3%,3.31% respectively,The sputum culture conversion rate of one drug resistance was 87.0%,the rate of two drugs resistance was71.4%,and the rate of three drugs resistance was 54.5%.Conclusion The drug resistance,especially multiple drug resistance was the main reason of the chemotherapy failure.