复治后耐多药结核发病治疗分析

Analysis of Multi-drug Resistance of Tuberculosis after Retreatment

目的:比较4种选药方案治疗复治后耐多药结核病的治疗疗效。方法:回顾性分析152例复治后耐多药结核病例,按治疗方案分为4组。Ⅰ组采用标准化疗方案HSRZE;Ⅱ组根据过去的治疗史组成个体化方案;Ⅲ组根据药敏试验组成个体化方案;Ⅳ组采用力克肺疾、左氧氟沙星、卷曲霉素、阿奇霉素、阿莫西林克拉维酸方案。结果:4组病灶吸收有效率分别为20.00%、47.37%、52.38%、81.48%;4组12个月疾菌阴转率分别为22.22%、57.89%、50.00%、81.48%。结论:对于所有复治肺结核患者均采用统一的标准复治方案有效率低,由力克肺疾、左氧氟沙星、卷曲霉素、阿奇霉素、阿莫西林克拉维酸联合组成的化疗方案是治疗复治后耐多药结核病的有效方案。

Objective： To compare the result of 4 kinds of combination medicine for antituberculosis in the cases of multi-drug resistance after treatment.Methods： One hundred and fifty-two cases with multi-drug resistance were retrospectively analyzed,and after retreatment they were divided into 4 groups according to treatment protocol： in group Ⅰ,standard chemical treatment protocol,i,e,HSREZ;in group Ⅱ,personal chemical treatment protocol according to previous treatment history;in group Ⅲ,treating the patients according to susceptible medicine test;in group Ⅳ,the patients were treated with pasiniazide,levofloxacin,capreomycin,amoxicillin-clavulanate with azithromycin.Results： Effective ratio for absorbed foci was around 20%,47.37%,52.38%,81.48% respectively;negative transformation ratio of the sputum tuberculosis was around 22.22%,57.89%,50%,81.48% respectively.Conclusion： Unified standard antituberculosis protocol has low effect for all patients undergoing retreatment,combining pasiniazide,levofloxacin、capreomycin,amoxicillin-clavulanate with azithromycin is more effective for multi-drug resistance of tuberculosis after retreatment.