肺结核病人耐药性分析与评价

AN ANALYSIS AND EVALUATION OF DRUG RESISTANCE IN PATIENTS WITH PULMONARY TUBERCULOSIS

①目的 探讨住院肺结核病人耐药现状 ,评价和指导临床用药。②方法 采用绝对浓度法对 2 76例痰结核菌涂片阳性病人进行 10种常用抗结核药物的耐药性检测。③结果 2 76例病人总耐药率为 62 .3 1% ,初治组和复治组耐药率分别为 5 5 .2 2 %和 81.3 3 % ,两组比较差异有显著性 ( χ2 =15 .86,P <0 .0 0 1)。 2 76例病人多药耐药率为 19.92 % ,初治组和复治组耐 2种或以上药物的耐药率比较差异有显著性 ( χ2 =7.12～ 3 1.3 9,P <0 .0 1、0 .0 0 1)。 10种药物中 ,初治组异烟肼耐药率最高 ,为 14.93 % ;复治组盐酸乙胺丁醇耐药率最高 ,为 2 6.67%。两组同性别间耐药率比较差异有显著性 ( χ2 =14.70 ,P <0 .0 0 1;χ2 =7.0 1,P <0 .0 1)。④结论 肺结核病人初始耐药率和获得性耐药率及多药耐药率仍处于较高水平 。

Objective To investigate and analyse present status of drug resistance of pulmonary-tuberculosis patients hospitalized and provide a guidance for clinical medication. Methods Ten commonly-used anti-tuberculosis drugs were tested for their sensitivity by absolute concentration method in 276 patients with smear positive of sputum tubercle bacillus. Results The total drug-resistance rate in 276 patients was 62.31%. The resistance of primary group and re-treated group was 55.22% and 81.33%, respectively(χ 2=15.86,P<0.001). Multi-drug-resistance (MDR) rate was 19.92% for all 276 patients. The difference between primary group and re-treated group was significant in terms of two-or-more-drug resistance rate (χ 2=7.12-31.39,P< 0.01,0.001). INH was found to be the highest, accounting for 14.93%, in primary group and EMB was 26.67% in re-treated group, respectively. The difference of drug resistance of the same sex between the two groups was statistically significant (χ 2= 14.70,P<0.001; χ 2=7.01,P<0.01). Conclusion The primary and acquired drug-resistance rates, as well as MDR, are still at higher level, a monitoring of tuberculosis should be further strengthened.