107例耐多药结核病耐药性分析

Study on Multidrug Resistance of 107 Cases of Tuberculosis

【目的】探讨耐多药结核(MDRTB)的耐药状况并分析其相关因素。【方法】采用匡氏琼脂培养基法进行结核杆菌分离培养及四种抗痨药物:异烟肼(H)、利福平(R)、链霉素(S)、乙胺丁醇(E)药敏试验,筛选出107例耐多药性肺结核病例,分析其耐药种类及耐药形成原因。【结果】107例原发性耐多药病例12例(11.2%),获得性耐多药病例95例(88.8%);耐多药病例以耐H、R、S和H、R、E和H、R、S、E为主(92.5%)。耐药形成原因中,化疗情况经统计学处理有明显差别(P<0.05),初治期间不规则用药和不满规定疗程自行停药共占72.6%,是MDR产生的主要原因;不同性别原发和获得性耐多药率相比较无明显差异(P>0.05)。【结论】耐多药的原因主要为不规则治疗所致,抓好初治病例合理化疗和贯彻全程督导治疗原则是防止耐多药产生的关键。

[Objective]To investigate multidrug resistance（MDR） of Mycobacterium tuberculosis（TB） and to analyze the factors associated with MDR-TB. [Methods]Strains of 107cases of MDR-TB were tested for resistance to isoniazid, rifampin, streptomycin and ethambotol by Kuang＇s agar culture methods. [Results]The ratio of primary MDR was 11.2%, the ratio of acquired MDR was 88.8%. The MDR strains were resistant to 3 and 4 kinds of antitubercnlosis drugs in large, and there were no significant difference between primary and acquired groups. The ratio of default in initial treatment in the cases of MDR-TB was 72.6 %, and there was no significant difference in initial treatment. [Conclusion]The cause of MDR-TB is mainly due to default in initial treatment ,and it is important to persist in chemotherapy regimes.