61例依赖利福平结核杆菌肺结核临床特点分析

Clinical characteristics of 61 patients with pulmonary tuberculosis caused by rifampin-dependent mycobacterium tuberculosis

目的:分析依赖利福平结核杆菌(简称依R菌)肺结核临床特点。方法:2008年10月至2012年1月在我院住院或门诊的61例依R菌肺结核患者,记录人口学资料、肺结核病程、抗结核药使用时间、结核病灶范围、是否合并空洞及数量、药敏试验结果、合并症。结果:61例依R菌肺结核患者中男40例,女21例。依R菌肺结核以中青年为主,30～44岁年龄组26例(42.62%)。均发生于继发性肺结核,合并症多。肺结核病情重,病情分级:中度者14例,重度41例。61株依R菌有52(85.24%)株耐2种及以上抗结核药,至少耐HR耐多药结核分枝杆菌(MDR-TB)的达49例(80.3%)。结论:依赖R菌肺结核患者以中青年为主,病情重。与耐多药肺结核的产生有相关性,需要早期发现依R菌肺结核,并实施合理正规化疗方案,才能控制依R菌肺结核的发展和蔓延。

Objective To analyze clinical characteristics of patients with pulmonary, tuberculosis caused by rifampin-dependent Myeobacterium tuberculosis. Methods Patients with pulmonary, tuberculosis caused by rifampindependent Myeohacterium tuberculosis in our hospital during October 2008 to January 2012 wereobserved. We recorded information including demographic data, course of pulmonary tuberculosis treatment time, size of nidus tubereulosis, numbers of pulmonary cavity, results of drug sensitive test, and complications. Results 61 patients were enrolled during the study period. The majority of patients were young to middle-aged There were 26 cases in the 30-44 age group （42.62%）. All 61 patients got secondary pulmonary., tuberculosis, and most of lhem experieneedcomplications. Of the 61 strains of rifampin-dependent Mycobacterium tuberculosis, 52 strains （85.24%） were resistant to two or more anti-tuberculosis drugs, and 49 strains （80.3%） were MDR- TB which were resistant 1o rifampin and isoniazide at least. Conclusion Rifampin-dependent Myeobacterium tubereuhosis-infected palients are mainly young and middle-aged groups with severe illness related with muhi-drug resistant tuherculosis. Therefore, we should early deteet rifampindependent Mycobaeterium tuberculosis, and implement a proper chemotherapy regimen. Only in this way can we control the development and spread of rifampin-dependent Myeobacterium tuberculosis.