抗结核药物耐药频率与使用时间的关系分析

目的探讨抗结核药物使用时间与耐药频率发生的关系。方法选取我所2000年1月～2006年12月门诊和住院肺结核患者痰结核杆菌培养599株阳性菌株,并应用改良罗氏培养基对阳性菌株进行利福平(RFP/R)、异烟肼(INH/H)、链霉素(SM/S)、乙胺丁醇(EMB/E)和丙硫异烟胺(TH1321/T)5种抗结核药物耐药性测定。结果结核分枝杆菌对所测定的5种抗结核药物药敏试验中,未使用抗结核药组及使用抗结核药物药<1个月组的耐药率最高为链霉素分别为9.1%、20.5%,最低是乙胺丁醇为0.3%、3.6%,随着使用抗结核药物时间的增长,耐药性出现一定的增加,其中3个月以上产生耐药频率最快的为利福平及异烟肼,分别达50%以上,3个月以上产生耐药频率最缓慢的是乙胺丁醇,低于20%。结论我们应加强分枝杆菌对药物耐药性的监测,选用敏感药物进行有规则和全程化疗,努力降低结核病的耐药率。

ANALYSIS OF THE RELATIONSHIP BETWEEN THE TIME OF USE AND THE FREQUENCY OF DRUG RESISTANCE IN ANTI-TUBERCULOSIS DRUGS

Objective Probe into the relationship between the time of use and the frequency of drug resistmace in anti - tuberculosis drugs. Methods Selected outpatient and inpatients with pulmonary tuberculosis smear positive in my Institute from Jan 2000 to 2006 Dec getting 599 strains, and determined Lowenstein - Jenson（ L - J） positive for the medium of rifampicin （ RFP/R）, isoniazid （ INH/H）, streptomycin （ SM./S）, ethambutol （EMB/E） and Protionamide（ TH1321/T）, five kinds of anti - TB drugs, resistance. Results M. tuberculosis in the determination of the five kinds of anti - tuberculosis drug susceptibility test, the group did not use anti - tuberculosis drugs and the group using anti -tuberculosis drugs 〈 1 month, with the highest rates of drug resistance as streptomycin were 9. 1%, 20.5%, and the lowest is ethambutol 0. 3%, 3.6%. Along with the use time of anti - TB drugs protracted, the drug resistance appears certain increase, of which the fastest increase of resistance rate are RFP and INH, both over 50% ; the lowest increase is EMB, less than 20%. Conclusion We should strengthen the drug resistance monitoring of Mycobacterium, choice of a drug - sensitive rules and the entire process of chemotherapy, efforts to reduce the rate of TB drug resistance.