201例结核病患者分离株的药敏结果分析

Analysis of drug susceptibility in 201 tuberculosis patients

本文旨在分析2008年12月～2009年5月就诊于上海市肺科医院的201例结核病患者结核分枝杆菌的药敏试验结果。结核分枝杆菌培养采用罗氏培养系统,药敏试验采用绝对浓度法。201例患者中,耐药率由高到低依次为异烟肼(INH,52.24%)、链霉素(SM,45.77%)、利福平(RFP,30.35%)、乙胺丁醇(EMB,28.86%)、阿米卡星(AK,28.18%)、利福喷汀(RIB,26.40%)、力克肺疾(Pa,25.56%)、对氨基水杨酸(PAS,23.60%)、丙硫异烟胺(Pt,23.03%)、卷曲霉素(CPM,20.56%)。其中,初治患者的耐药率为3.08%～26.15%,复治患者为27.50%～64.71%,耐多药患者为64.44%～100%。总体来看,与低浓度相比,高浓度SM、INH、EMB、RIB、Pt可明显降低结核分枝杆菌的耐药率(P<0.05)。除INH、SM、RFP外,女性患者的耐药率均高于男性,耐多药率亦高于男性(P<0.05)。结果提示,临床上应足量应用抗结核药物,对女性结核病患者要给予更多关注。

The paper aims to investigate the susceptibility test results of 201tuberculosis patients in Shanghai Pulmonary Hospital from December 2008to May 2009.Roche system was used to culture Mycobacterium tuberculosis（M.tuberculosis）,and absolute concentration method was used to test drug susceptibility.In 201patients,the resistance rates of M.tuberculosis were as follows：isoniazid （INH,52.24%）,streptomycin（SM,45.77%）,rifampicin（RFP,30.35%）,ethambutol（EMB,28.86%）,amikacin（AK,28.18%）,rifapentine （RIB,26.40%）,pasiniazide （Pa,25.56%）,paraminosalicylic acid （PAS,23.60%）,protionamide（Pt,23.03%）,capreomycin （CPM,20.56%）.Among all the patients,drug resistance rates in patients being treated for the first time was 3.08%-26.15%,whereas in previouslytreated patients the rate was 27.50%-64.71%,and in multidrug-resistant patients the rate was 64.44%100%.Overall,compared with low concentrations of drugs,high concentrations of SM,INH,EMB,RIB,and Pt decreased the resistance rate of M.tuberculosis significantly（P0.05）.Except for INH,SM,and RFP,higher drug resistance rates and multidrug resistance rates were observed in females compared with males（P0.05）.These results suggest that the application of anti-tuberculosis drugs should be clinically adequate,and more attention should be paid to gender-related differences in drug resistance.