天津地区296例老年肺结核住院患者耐药状况分析

Analysis of drug-resistant tuberculosis in 296 elderly inpatients in Tianjin

目的 了解天津地区住院老年肺结核患者耐药情况,探讨老年肺结核的耐药特点.方法 收集天津市海河医院2008年1月至2009年9月296例痰结核菌培养阳性的老年肺结核住院患者的4种常用抗结核药物耐药检测资料.与549例同期非老年肺结核患者进行比较和回顾性分析.结果 （1）入选老年组患者296例,总耐药率为28.7%、耐多药率为8.8%;其中初始耐药率、耐多药率、获得性耐药率和耐多药率分别为22.2%、6.1%、41.8%和14.3%.（2）对任一抗结核药累计耐药顺序为异烟肼＞链霉素＞利福平＞乙胺丁醇.（3）性别间耐药率差异无统计学意义（x2=0.002,P＞0.O5）.（4）老年组耐药率及耐多药率明显低于非老年组（x2值分别为10.8、5.24,均P＜0.05）.结论 老年肺结核患者耐药率低于非老年患者.

Objective To realize the feature of drug resistance in elderly inpatients with tuberculosis in Tianjin. Methods The data of anti-tuberculosis drug sensitivity test of 296 elderly inpatients in Tianjin Haihe Hospital were collected from January 2008 to September 2009. And they were retrospectively analyzed compared with the non-elderly tuberculosis inpatients in the same period.Results （1）The 296 elderly patients with pulmonary tuberculosis were enrolled in this study. The total rate of drug resistance was 28.7% and total rate of multi-drug resistance was 8.8 %. The initial drug resistance rate was 22.2% and initial multi-drug resistance rate was 6.1%. The acquired drug resistance rate was 41.8% and acquired multi-drug resistance rate was 14.3%. （2）The order of drug resistance rate from high to low was isoniazid, streptomycin, rifampin and ethambutal, respectively.（3） The drug resistance rate did not show significant difference among different sex groups （x2 =0. 002, P＞0. 05）. （4）The drug resistance rate and multi-drug resistance rate between elderly patients and non-elderly patients had significant differences （x2 = 10.8, 5.24, both P＜0.05）. Conclusions The proportion of elderly patients with pulmonary tuberculosis is high, however, its drug resistance rate and multi-drug resistance rate are much lower than non-elderlies.