摘要
目的了解住院的首次复治肺结核病人的基本情况,为制定规范合理的化疗方案,提高治愈率和加强防治管理工作提供依据。方法回顾性调查和分析2003年1月—2005年12月在上海市肺科医院住院的肺结核病人中属于首次复治的病人的临床特点和导致复治的可能危险因素。结果首次复治病人498例,占同期所有住院肺结核病人的13.1%。涂阳病人占52.8%。S,H,R,E耐药率分别为34.8%,46.8%,28.4%和24.8%。同时耐异烟肼利福平者占26.2%。51.7%有不同程度的合并症,其中以合并糖尿病、肝脏基础疾病及低蛋白血症最为常见。有81例次在本次住院前后发生了药物不良反应。35.1%的患者有不规则治疗史,导致不规则治疗原因以药物不良反应为最多见。本市初次复治病人以45岁以上年龄组(70%)为多,特别是60岁以上占43.7%。非本市病人在小于45岁年龄组占60%以上。结论住院治疗的首次复治病人有其特殊性。耐药、基础情况差、合并症多、合并有肺外结核、营养不良、药物不良反应多及不规则治疗可能是导致复治肺结核的危险因素。
Objective To study the baseline data of inpatients who received retreatment of antituberculosis as the first time, so as to provide evidence for making standardized and reasonable chemotherapy regimen, and to increase cure rate and strengthen management work of prevention and treatment. Methods We investigated and analysed retrospectively clinical characteristics and risk factors of inpatients with pulmonary tuberculosis who received the first retreatment in Shanghai Pulmonary Hospital from January 2003 to December 2005. Results Among the inpatients with pulmonary tuberculosis, there were 498 patients who were retreated as the first time, accounting for 13.1% of all the inpatients with pulmonary tuberculosis during the same period. The rate of sputum smear positive was 52.8%. The drug resistant rates of streptomycin, isoniazid, rifampicin and ethambutol were 34. 8%, 46. 8%, 28. 4%/40 and 24. 8% respectively. The drug resistant rate of isoniazid combinated with rifampicin was 26.2%. 51.7% of the patients had complications in various degrees and the most common complications were diabetes, basic liver disease and hypoproteinemia. Drug-reltated adverse effects before or after this hospitalization was 81 case-times. 35.1% of the patients had irregular antituberculosis treatment history caused often by drug-related adverse effects. The patients greater than 45-year old with first retreatment from Shanghai acconted for approximately 70% ,and especially patients greater than 60-year old accounted for 43.7%. However,about 60% of patients from other cities was less than 45-year old. Conclusions The first time retreated inpatients have particular characteristics. Drug resistance, poor basic conditions, many complications, complicated extra-pulmonary tuberculosis, malnutrition, drug-related adverse reactions and irregular treatment are risk factors of retreated tuberculosis.
出处
《中国防痨杂志》
CAS
2010年第1期1-5,共5页
Chinese Journal of Antituberculosis
关键词
结核
肺/治疗
再治疗
上海市
tuberculosis, pulmonary
retreatment
Shanghai city