耐多药肺结核与结核分枝杆菌L型感染的临床研究

A clinical study on the infection of multiple-drug resistance pulmonary tuberculosis and L-forms of mycobacterium tuberculosis

目的 :探讨结核分枝杆菌L型在耐多药肺结核形成及治疗过程中的变化规律 ,提高痰菌阴性肺结核的阳性诊断率。方法 :对 60例耐多药肺结核 ,40例无耐药初治肺结核病人分别于治疗前 ,治疗 1个月 ,治疗 3个月做痰结核分枝杆菌培养和结核分枝杆菌L型检测。结果 :初治无耐药肺结核分枝杆菌L型阳性率 (12 5 % )明显低于耐多药肺结核 (5 3 3 % )。随着耐药种类的增多 ,结核分枝杆菌L型阳性率增高 ;痰菌阴性的肺结核患者痰结核分枝杆菌L型仍可阳性。结论 :耐多药肺结核病人有较高的结核分枝杆菌L型感染率 ;复治 ,病情进展恶化 。

Objective: To explore the changes of L forms of mycobacterium tuberculosis(LMT) in the procession of formation in multiple drug resistance pulmonary tuberculosis (MDR PTB) and its treatment,improving the diagonsis rate of pulmonary tuberculosis with negative sputum bacterium.Methods: Before and after 1 month,3 month treatment the patients including 60 cases of MDR PTB and 40 cases of primary treated,no drug resistance pulmonary tuberculosis were completed with the culture of sputum bacterium and examined for LMT.Results: The positive rate of LMT in the patients with no drug resistance pulmonary tuberculosis (12 5%) is lower significantly than that in the patient with MDR PTB(53 3%).And along with the increasement of drug resistance bacterial types,the positive rate of LMT increased.The patients with negative spation bacterium could be still positive of LMT.Conclusion: The infections rate in the patients with MDR PTB was relatiuly high.The patients with seconday treatment,exacerbation of illness and drug resistance,might be associated with the infection of LMT.