150例耐多药肺结核的成因分析和治疗探讨

Analysis of causes of drug resistance and probe of therapy on 150 multi-drug resistant pulmonary tuberculosis patients

目的分析多种耐药结核病(MDR-TB)的成因并观察左氧氟沙星联合其它二线抗结核药物治疗的近期疗效。方法对我院2002年1月～2003年12月收治的150例耐多药肺结核的成因进行回顾性分析和含左氧氟沙星的多药联合方案的疗效结果MDR患者64%由不规则治疗所致,20%由初治化疗方案不合理所致,16%系原发耐药,满疗程痰菌阴转率88%。结论加强宣教,严格管理,合理使用短程化疗,初治患者的规范化治疗是防止MDR的关键。对MDR-TB采用含左氧氟沙星联合其它二线药物治疗在临床上是可行和安全的。

Objective To analysis the causes of multi-drug resistant tuberculosis （MDR-TB） and to evaluate the effects of chemotherapy wiht lev-ofloxacin and other antituberculosis drugs. Method 150 cases with MDR-TB treated in the hospital from January 2002 to December 2003 were analyzed. Results 64% of the MDR-TB patients were due to irregular treatment, 20% were caused by improper theatment, and 16% were caused by original drug resistant. The sputum culture conversion rate at end of treatment was 88% Conclusions MDR-TB might be prevented by a combination of health education and rational use of short-course chemotherapy. Lev-ofloxacin and other second-line anti-tuberculosis drugs are effective and were tolerated in treating patients with NDR-TB.