110例耐药肺结核病临床特征分析

Discussion of the dinical features of 110 cases with drug-resistant tuberculosis

目的 通过对耐药肺结核病的临床特征分析,了解患者结核分枝杆菌的耐药程度、病情变化、治疗效果等.方法 搜集2009年1月至2012年12月深圳慢性病防治中心110例耐药肺结核患者.对患者进行痰涂片检查、改良罗氏培养、菌型鉴定、药物敏感性试验（简称“药敏试验”）、胸部X线检查等,观察患者治疗后病灶变化、药物不良反应等,并且组织专家讨论,进行全面的评估.结果 110例耐药肺结核患者主要症状为咳嗽、咯痰;耐多药患者占21.8％（24/110）,耐3种及以上药物的患者占19.1％（21/110）;病灶多累及双侧肺野,达57.3％（63/110）;痰涂片检查结果“＋＋＋”及以上患者占30.9％（34/110）;80.9％（89/110）的患者病灶显著吸收或部分吸收.耐药肺结核患者治疗成功率为76.4％（84/110））,治疗失败率为13.6％（15/110）.结论 耐药肺结核呼吸道症状明显,耐多药和多耐药肺结核患者所占比率较高,对肺组织损害程度严重.要加强耐药结核病防治工作,控制结核的传播.

Objective To analyze the clinical features of drug-resistant tuberculosis, and to understand mycobacteria, patient＇s conditions and outcomes of treatment in drug-resistant rib patients. Methods The clinical data of 110 drug-resistant TB cases, at Shenzhen Chronic Disease Control and Prevention Centre from January 2009 to December 2012, were collected. Patients were assayed with smear, culture, X-Ray, bacterial identification and drug sensitivity test, etc. Effects and side effects were observed during treatment. A comprehensive assessment was con- ducted by experts through discussion. Results The prominent symptoms of 110 cases of drug-resistant TB were cough and expectoration. Amongst all patients, 21.8 % （24/110） demonstrated Multi-drug resistant tuberculosis, and 19.1% （21/110） contracted tuberculosis resistant to 3 and more drugs. 57.3% （63/110） of patients had bilateral lung field affected. The rate of ＋ ＋ ＋ and above among the patients with sputum smear ＋ was 30. 9% （34/110）. The rate of lesions absorption was 80. 9% （89/110）. The rate of successful treatment was 76.4% （84/110）, while that of failure amounted to 13.6% （15/110）. Conclusion The drug-resistant tuberculosis pos sesses apparent respiratory manifestation, It was shown there had been a high percentage of multi-drug resistant TB and poly-resistant TB, damaging the lung severely. We should enhance drug-resistant tuberculosis control and reduce the propagation of drug-resistant TB.