228例初治培阳肺结核病人短化疗效与耐药性分析

Analysis of the relationship between the drug-resistance and the short-course chemotherapy effect in 228 pulmonary tuberculosis patients

目的 分析 2 2 8例初治培阳肺结核病人其耐药性与短化疗效的关系。方法 病人治疗采用全程隔日间歇短化方案 ,( 2R3H3E3Z3/4R3H3)。采用绝对浓度法进行药敏测定。结果 33例初治耐药肺结核病例 ,经 6个月正规短程化疗失败率高达 12 .1%。 ( 1)对耐R类药物者化疗失败率为 4 0 %( 2 /5) ,敏感组化疗失败率为 2 .6% ( 5/195) ,两组有显著性差异 (P <0 .0 5) ;( 2 )对其他类 (不含耐R类 )化疗失败率为 7.1% ,与敏感组比较无显著性差异 (P >0 .0 5)。二年随访耐药组细菌复发率为3.5% ,敏感组细菌复发率为 1.1%。结论 药物敏感病例和耐 1种或 2种药的病例 (不含耐R类 )采用 6个月短程化疗方案是合理有效的。

Objective To analyze the relationship between the drug resistance and the short course chemotherapy effect in 228 new smear positive pulmonary tuberculosis patients.Methods The treatment regimens of 228 cases were short course intermittent chemotherapy,and all cases had been done the susceptibility tests with absolute concentration method.Results After complete the 6 months treatment course,the rate of failure in 33 drug resistant cases was 12.1%. (1)In R resistant cases and drug sensitive cases,the rate of failure was respectively 40% (2/5) and 2.6%(5/195).There were significantly difference ( P< 0.05).(2)In the other drug resistant cases (except R resistant cases),the rate of failure was 7.1%,and it was no significantly difference from drug sensitive cases ( P >0.05).The check in 2 years showed that the positive conversion rate was 3.5% in drug resistant cases,and 1.1% in drug sensitive cases.Conclusion It is reasonable and effective to cure drug sensitive cases and drug resistant cases (except R) with the short course intermittent chemotherapy.