26例耐多药肺结核病例治疗临床分析

Analysis of therapeutic effect of 26 patients with multi-drag resistant pulmonary tuberculosis

目的 分析2 6例耐多药肺结核病人个体化综合治疗的疗效。方法 将耐药病人分成两组,一般耐药组(Ⅰ组)和耐多药组(Ⅱ组)制定个体化方案。观察痰菌阴转率和X线好转率。结果 两组病例治疗6、1 2及2 4个月,痰菌阴转率及X线好转率分别:Ⅰ组:70 %、50 % ;90 %、90 % ;90 %、90 %。Ⅱ组:62 .5 %、43 .75 % ;87.5 %、75 % ;81 .3 %、81 .3 %。两组疗效比较有显著性差异(P <0 .0 5)。结论 个体化方案治疗失败与耐多种药物,肺部不可逆性病变及病变广泛有关,根据药敏结果及早建立个体化的合理有效的化疗方案对MDR TB十分重要。

Objective To observe and analyze the therapeutic effects of individualized regimens of 26 patients with multi-drug resistant pulmonary tuberculosis (MDR-TB). Methods The patients were divided into 2 groups according to the result of susceptibility test.: the general drug-resistance group (G-I) and individualized drug-resistance group (G-II). For G-II, the patients received individualized regimens for treatment. Sputum negative conversion rates and chest X-ray improvement rates were observed for 6, 12 and 24 months. Results The sputum conversion rates and chest X-ray improvement rates in G-I were 70%, 50% for 6 months; 90%, 90%, for 12 months and 90% and 90% for 24 months, respectively. For G-II the respective rates were 62.5%, 43.75% for 6 months; 87.5%, 75% for 12 months and 81.3%, 81.3% for 24 months, respectively. The rates of G-I were significantly higher than that of G-II (p<0.05). Conclusion Individualized regimens and therapeutic effects are associated with the number of resistant drugs and irreversible lesions. Timely individualized regimens provided to MDR-TB patients based on the susceptibility test is important for the treatment.