淮北矿区尘肺结核病人耐药性的研究

Drug Resistance of the Silicosis Tuberculosis Patients in Huaibei Coalmine

目的探讨淮北矿区尘肺结核病人的耐药情况,为临床制定化疗方案及预防措施提供科学依据。方法对活动性尘肺结核病人按《全国结核病细菌学检验规程》的要求,用改良罗氏法进行痰结核杆菌培养,培养阳性菌株采用绝对浓度间接法进行6种抗结核药物的耐药性测试。结果尘肺结核病人的痰结核分枝杆菌培养阳性55例,耐药38例,总耐药率为69.1%。初始耐药率为33.3%,耐多药率为11.1%;获得性耐药率为86.5%,耐多药率为45.9%。抗结核药的耐药顺位为R、H、Z、S、P、E。结论尘肺结核病人耐药情况不容乐观,应加强对尘肺结核病人尤其是耐药结核病人临床治疗的管理,制定合理的化疗方案至关重要。

[ Objective] To explore the drug resistance of silicosis tuberculosis patients in HuaiBei coalmine and provide scientific evidence for the establishment of chemotherapy project. [ Methods] According to the requirement in the National Regulation for the Tuberculosis Bacteriological Detection, reformed LJ method was applied for the cultivation of tuberculosis mycobacterium; absolute concentration indirect method was used to determine the drug resistance against 6 types of anti-tuberculosis drugs. [ Results] 55 cases were found positive, 38 cases had drug resistance with a total drug resistance rate of 69.1% ; preliminary drug resistance rate was 33.3% , multi drug resistance rate of which was 11.1% ; acquired drug resistance rate was 86.5% ; multi drug resistance rate of which was 45.9% ; the order of drug resistance against tuberculosis drugs were R, H, Z, S, P and E. [ Conclusion] The drug resistance situation among the silicosis tuberculosis patients is not satisfactory; clinical management should be improved especially on the drug resistant tuberculosis patients.