肺结核患者氯法齐明耐药情况分析

Analysis of resistance to clofazimine in tuberculosis patients

目的分析肺结核患者对氯法齐明的耐药情况。方法回顾性分析2015年1月至2018年6月首都医科大学附属北京胸科医院结核科1770例肺结核患者的病例资料,其中男1225例,女545例,年龄8~92(43.2±15.2)岁。采用比例法药物敏感试验(简称药敏试验)对结核菌株进行抗结核药物耐药性检测,计数资料采用χ^(2)检验或Fisher精确检验。结果1770例结核患者中,对氯法齐明敏感患者1713例,耐药患者57例,耐药率为3.2%(57/1770),其中复治患者氯法齐明耐药率明显高于初治患者[5.8%(38/656)比1.7%(19/1114),χ^(2)=22.129,P=0.000];多耐药、耐多药及广泛耐药患者对氯法齐明耐药率分别为1.0%(17/1770)、1.2%(21/1770)、1.1%(19/1770);有住院史的耐氯法齐明的耐多药及广泛耐药患者耐药率2.4%(14/594)、2.7%(16/594)分别高于无住院史的患者0.6%(7/1176)、0.3%(3/1176),差异均有统计学意义(χ^(2)=10.447、22.099,P=0.001、<0.001)。结论肺结核患者对氯法齐明的耐药率较低,可提高耐药肺结核病患者治疗成功率,具有较好的应用价值。

Objective To analyze the drug resistance of tuberculosis patients to clofazimine.Methods Retrospective analysis was conducted on the case data of 1770 tuberculosis patients in Department of tuberculosis,Beijing Chest Hospital affiliated to Capital Medical University from January 2015 to June 2018,including 1225 males and 545 females,aged 8-92(43.2±15.2)years old.Drug sensitivity tests using proportion method(hereinafter referred to as drug susceptibility test)for TB strains anti-tb drug resistance test.Using χ^(2) test or Fisher′s exact test.Results 1770 cases of tuberculosis patients,1713 cases of patients with clofazimine sensitive,of 57 patients with drug resistance,and resistant rate was 3.2%(57/1770),including patients with recurrent clofazimine,significantly higher than the initial percentages of patients[5.8%(38/656),1.7%(19/1114),χ^(2)=22.129,P=0.000,P<0.01];The drug resistance rates of poly-resistant,multi-drug resistant and extensively resistant patients to clofazimine were 1.0%(17/1770),1.2%(21/1770)and 1.1%(19/1770),respectively.Has a history of hospitalization of clofazimine resistance of multidrug-resistant and extensively drug-resistant patients resistant rate 2.4%(14/594),2.7%(16/594),respectively,higher than 0.6%(7/1176)with no history of hospitalized patients,0.3%(3/1176),the differences were statistically significant(χ^(2)=10.447,22.099,P=0.001,<0.001).Conclusion Clofazimine has a low resistance rate,which can improve the treatment success rate of patients with drug-resistant tuberculosis and has important value.