结核分枝杆菌L型与耐多药肺结核关系的研究

Clinical Study on Infection of Multiple-drug Resistance Pulmonary Tuberculosis and L-forms of Mycobacterium Tuberculosis

目的 探讨结核分枝杆菌L型 (MTB -L)在耐多药肺结核 (MDR -PTB)形成及治疗过程中的变化特点 ,为临床诊治提供依据和方法。方法 对 4 0例耐多药肺结核、30例无耐药初治肺结核患者 ,治疗前分别做痰和支气管肺泡灌洗液的结核分枝杆菌培养和结核分枝杆菌L型检测。结果 耐多药肺结核结核分枝杆菌L型阳性率 (支气管肺泡灌洗液 5 2 5 % ,痰 5 0 % )明显高于无耐药初治肺结核 (支气管肺泡灌洗液 1 6 7% ,痰 1 3 3% )。随着耐药种类的增多 ,结核分枝杆菌L型阳性率增高。结论 耐多药肺结核患者有较高的结核分枝杆菌L型感染率 ;复发、耐药。

Objective To explore the formation and changes in therapy process of L-forms of mycobacterium tuberculosis(MTB-L) in multi-drug resistance pulmonary tuberculosis(MDR-PTB),giving evidence and methods to clinical diagnosis and treatment.Methods 40 cases with multi-drug resistance pulmonary tubercrlosis and 30 cases with first-treated non-drug resistance pulmonary tubereculosis were pre-therapy respectively cultured for mycobacterium tuberculosis from sputum and broncholaveoclysis liquid and tested for LMT.Results The positive rate of LMT in patients with MDR-PTB(bronchoalveoclysis liquid is 52 5% and sputum 50%)is significantly higher than that in patients with non-drug resistance pulmonary tuberculosis(bronchoalveoclysis liquid is 16 7% and sputum 13 3%) The more drug resistance bacterial types are,the higher positive rate of LMT is.Conclusion A relatively higher LMT infection rate was found in the patients with MDR-PTB Second treatment、drug resistance and exacerbation of illness might be associated with the infection of LMT