期刊文献+
共找到1,968篇文章
< 1 2 99 >
每页显示 20 50 100
Drug Resistance Pattern in Pulmonary Tuberculosis Patients and Risk Factors Associated with Multi-Drug Resistant Tuberculosis 被引量:3
1
作者 S. Maharjan A. Singh +1 位作者 D. K. Khadka M. Aryal 《Journal of Tuberculosis Research》 2017年第2期106-117,共12页
Introduction: Anti-tuberculosis drug resistance is a major problem in tuberculosis (TB) control programme, particularly multi-drug resistance TB (MDR-TB) in Nepal. Drug resistance is difficult to treat due to its asso... Introduction: Anti-tuberculosis drug resistance is a major problem in tuberculosis (TB) control programme, particularly multi-drug resistance TB (MDR-TB) in Nepal. Drug resistance is difficult to treat due to its associated cost and side effects. The objective of this study was to assess the drug resistance pattern and assess risk factor associated with MDR-TB among pulmonary tuberculosis patients attending National Tuberculosis Center. Methodology: The comparative cross sectional study was conducted at National Tuberculosis Center during August 2015 to February 2015. Early morning sputum samples were collected from pulmonary tuberculosis suspected patients and subjected to Ziehl-Neelsen staining and fluorochrome staining and culture on Lowenstein-Jensen (LJ) medium. Drug Susceptibility test was performed on culture positive isolates by using proportion method. Univariate and multivariate analysis was computed to assess the risk factors of MDR-TB. Results: Out of 223 sputum samples, 105 were fluorochrome staining positive, 85 were ZN staining positive and 102 were culture positive. Out of 102 culture positive isolates, 37.2% were resistance to any four anti-TB drugs. 11 (28.9%) were initial drug resistance and 28 (43.7%) were acquired drug resistance. The overall prevalence of MDR-TB was 11.7%, of which 2 (5.3%) were initial MDR-TB and 10 (15.6%) were acquired MDR-TB. Univariate and multivariate analysis showed female were significantly associated (P = 0.05) with MDR-TB. Conclusion: Drug resistance TB particularly MDR-TB is high. The most common resistance pattern observed in this study was resistance to both isoniazid and rifampicin. Female were found to be associated with MDR-TB. Thus, early diagnosis of TB and provision of culture and DST are crucial in order to combat the threat of DR-TB. 展开更多
关键词 tuberculosis pulmonary tuberculosis ANTI-tuberculosis drug Resistance MDR-TB
下载PDF
Clinical Study of Drug-resistant Pulmonary Tuberculosis Treated by Combination of Anti-Tuberculosis Chemicals and Compound Astragalus Capsule(复方黄芪胶囊) 被引量:3
2
作者 姜艳 李新 +2 位作者 于志勇 尹红义 韩玉庆 《Chinese Journal of Integrated Traditional and Western Medicine》 2004年第2期102-106,共5页
Objective: To observe and evaluate the therapeutic effect of anti-tuberculosis (anti-TB) chemicals and Compound Astragalus Capsule (CAC) in combinedly treating drug resistant pulmonary tuberculosis (DR-TB). Methods: N... Objective: To observe and evaluate the therapeutic effect of anti-tuberculosis (anti-TB) chemicals and Compound Astragalus Capsule (CAC) in combinedly treating drug resistant pulmonary tuberculosis (DR-TB). Methods: Ninety-two patients with DR-TB were equally randomized into the treated group (treated with combination therapy) and the control group (treated with anti-TB chemicals alone). The therapeutic course for both groups was 18 months. Therapeutic effects between the two groups were compared at the end of the therapeutic course. Sputum bacterial negative rate, focal absorption effective rate, cavity closing rate, 10-day symptom improving rate, the incidence of adverse reaction and 2-year bacteriological recurrence rate between the two groups were compared. Results: In the treated group, the sputum bacterial negative conversion rate was 84. 8% , focal absorption effective rate 91. 3% , cavity closing rate 58. 7% and 10-day symptom improving rate 54. 4% , while in the control group, the corresponding rates were 65.2% , 73. 9 % , 37.0% and 26.1 % , respectively. Comparison between the groups showed significant difference in all the parameters (P<0.05, P<0.05, P<0.05 and P<0.01). The incidence of adverse reaction and 2-year bacteriological recurrence rate in the treated group were 23. 9% and 2.6% respectively, while those in the control group 50. 0% and 16. 7% , which were higher than the former group with significant difference ( P<0. 01 and P<0. 05, respectively). Conclusion: The therapeutic effect of combined treatment with anti-TB and CAC is superior to that of treatment with anti-TB chemicals alone, and the Chinese herbal medicine showed an adverse reaction alleviating effect, which provides a new therapy for DR-TB, and therefore, it is worth spreading in clinical practice. 展开更多
关键词 pulmonary tuberculosis drug resistance Chinese and Western drugs drug therapy
下载PDF
Comparison of Two Molecular Assays For Detecting Smear Negative Pulmonary Tuberculosis 被引量:5
3
作者 LI Qiang BAO Xun Di +3 位作者 LIU Yun OU Xi Chao PANG Yu ZHAO Yan Lin 《Biomedical and Environmental Sciences》 SCIE CAS CSCD 2016年第4期248-253,共6页
Objective To compare the performance of MTBDRplus V2 and Xpert MTB/RIF for detecting smear negative pulmonary tuberculosis (PTB). Methods Clinical PTB suspects were enrolled consecutively in Anhui Chest Hospital and... Objective To compare the performance of MTBDRplus V2 and Xpert MTB/RIF for detecting smear negative pulmonary tuberculosis (PTB). Methods Clinical PTB suspects were enrolled consecutively in Anhui Chest Hospital and Xi'an Chest Hospital from January to December in 2014. The sputum samples of smear negative PTB suspects were collected and decontaminated. The sediment was used to conduct MTBDRplus V2, Xpert MTB/RIF and drug susceptibility test (DST). All the samples with discrepant drug susceptibility result between molecular methods and phenotypic method were confirmed by DNA sequencing. Results A total of 1973 cases were enrolled in this study. The detection rates of Mycobacterium tuberculosis complex (MTBC) by MTBDRplus V2 and Xpert MTB/RIF were 27.67% and 27.98%, respectively. When setting MGIT culture result as a gold standard, the sensitivity and specificity of MTBDRplus V2 were 86.74% and 93.84%, and the sensitivity and specificity of Xpert MTB/RIF were 86.55% and 93.43%, respectively. For the detection of the resistance to rifampin, the sensitivity and specificity of MTBDRplus V2 were 94.34% and 96.62%, and the sensitivity and specificity of Xpert MTB/RIF were 88.68% and 95.96%, respectively. For the detection of the resistance to isoniazid, the sensitivity and specificity of MTBDRplus V2 were 77.38% and 98.02%, respectively. Conclusion MTBDRplus V2 and Xpert MTB/RIF can be used to detect MTBC in smear negative samples with satisfactory performance. 展开更多
关键词 Smear negative pulmonary tuberculosis Diagnosis drug resistance
下载PDF
Esophageal tuberculosis complicated with intestinal tuberculosis: A case report 被引量:1
4
作者 Lei Mao Xue-Ting Zhou +5 位作者 Ji-Pin Li Jun Li Fang Wang Hui-Min Ma Xiao-Lu Su Xiang Wang 《World Journal of Clinical Cases》 SCIE 2020年第3期645-651,共7页
BACKGROUND Although the overall incidence of tuberculosis in underdeveloped areas has increased in recent years, esophageal tuberculosis(ET) is still rare. Intestinal tuberculosis(ITB) is relatively more common, but t... BACKGROUND Although the overall incidence of tuberculosis in underdeveloped areas has increased in recent years, esophageal tuberculosis(ET) is still rare. Intestinal tuberculosis(ITB) is relatively more common, but there are few reports of ET complicated with ITB. We report a case of secondary ET complicated with ITB in a previously healthy patient.CASE SUMMARY A 27-year-old female was hospitalized for progressive dysphagia, retrosternal pain, acid regurgitation, belching, heartburn, and nausea. Upper gastrointestinal endoscopy showed a mid-esophageal ulcerative hyperplastic lesion. Endoscopic ultrasonography showed a homogeneous hypoechoic lesion, with adjacent enlarged lymph nodes. Biopsy histopathology showed inflammatory exudation,exfoliated epithelial cells and interstitial granulation tissue proliferation.Colonoscopy revealed a rat-bite ulcer in the terminal ileum and a superficial ulcer in the ascending colon, near the ileocecal region. The ileum lesion biopsy showed focal granulomas with caseous necrosis. Polymerase chain reaction for Mycobacterium tuberculosis was positive in the esophageal and ileum lesion biopsies. The T-cell spot tuberculosis test was also positive. The patient was diagnosed with secondary ET infiltrated by mediastinal lymphadenopathy and complicated with ITB, possibly from the Mycobacterium tuberculosis-infected esophageal lesion. After 2 mo of anti-tuberculosis therapy, her symptoms improved significantly, and upper gastrointestinal endoscopy showed healing ulcers.CONCLUSION When dysphagia or odynophagia occurs in patients at high-risk for tuberculosis,ET should be considered. 展开更多
关键词 Esophageal tuberculosis Intestinal tuberculosis DYSPHAGIA ENDOSCOPIC
下载PDF
Efficacy of integrating short-course chemotherapy with Chinese herbs to treat multi-drug resistant pulmonary tuberculosis in China: a study protocol 被引量:1
5
作者 Shun-Xian Zhang Lei Qiu +9 位作者 Cui Li Wei Zhou Li-Ming Tian Hui-Yong Zhang Zi-Feng Ma Xian-Wei Wu Xing Huang Yu-Wei Jiang Shao-Yan Zhang Zhen-Hui Lu 《Infectious Diseases of Poverty》 SCIE 2021年第6期90-105,共16页
Background:Tuberculosis(TB)causedMycobacterium tuberculosis(M.tb)is one of infectious disease that lead a large number of morbidity and mortality all over the world.Although no reliable evidence has been found,it is c... Background:Tuberculosis(TB)causedMycobacterium tuberculosis(M.tb)is one of infectious disease that lead a large number of morbidity and mortality all over the world.Although no reliable evidence has been found,it is considered that combining chemotherapeutic drugs with Chinese herbs can significantly improves the cure rate and the clinical therapeutic effect.Methods:Multi-drug resistant pulmonary tuberculosis(MDR-PTB,n=258)patients with Qi-yin deficiency syndrome will be randomly assigned into a treatment group(n=172)or control/placebo group(n=86).The treatment group will receive the chemotherapeutic drugs combined with Chinese herbs granules(1+3 granules),while the control group will receive the chemotherapeutic drugs combined with Chinese herbs placebo(1+3 placebo granules).In addition,MDR-PTB(n=312)patients with Yin deficiency lung heat syndrome will be randomly assigned to a treatment(n=208)or control/placebo(n=104)group.The treatment group will receive the chemotherapeutic regimen combined with Chinese herbs granules(2+4 granules),while the control group will receive the chemotherapeutic drugs and Chinese herbs placebo(2+4 placebo granules).The primary outcome is cure rate,the secondary outcomes included time to sputum culture conversion,lesion absorption rate and cavity closure rate.BACTEC^(TM)MGIT^(TM)automated mycobacterial detection system will be used to evaluate theM.tb infection and drug resistance.Chi-square test and Cox regression will be conducted with SAS 9.4 Statistical software to analyze the data.Discussion:The treatment cycle for MDR-PTB using standardized modern medicine could cause lengthy substantial side effects.Chinese herbs have been used for many years to treat MDR-PTB,but are without high-quality evidence.Hence,it is unknown whether Chinese herbs enhances the clinical therapeutic effect of synthetic drugs for treating MDR-PTB.Therefore,this study will be conducted to evaluate the clinical therapeutic effect of combining Chinese herbs and chemotherapeutic drugs to treat MDR-PTB cases.It will assist in screening new therapeutic drugs and establishing treatment plan that aims to improve the clinical therapeutic effect for MDR-PTB patients.Trial registration This trial was registered at ClinicalTrials.gov(ChiCTR1900027720)on 24 November 2019(prospective registered). 展开更多
关键词 pulmonary tuberculosis MULTIdrug-RESISTANT Chemotherapeutic drug Chinese herbs Randomized controlled trial
原文传递
An epidemiological study of resistant tuberculosis in Chongqing,China
6
作者 Xiang Ying Ying Li +6 位作者 Liu Jie Su Qian Shen Jing Zhan Jian Xu Rufu Xiong Hongyan Lin Hui 《Journal of Medical Colleges of PLA(China)》 CAS 2011年第3期158-173,共16页
Background The epidemiological characteristics of drug-resistant tuberculosis(DR-TB)is fundamental to improving the prevention and control of DR-TB.Mutations in katG315 is thought to be the most predictive molecule ma... Background The epidemiological characteristics of drug-resistant tuberculosis(DR-TB)is fundamental to improving the prevention and control of DR-TB.Mutations in katG315 is thought to be the most predictive molecule markers for Isoniazid(INH)resistance in Mycobacterium tuberculosis(MTB).However,mutations to these genes have not been thoroughly studied in China,and epidemiological evidence of their expression levels are especially lacking in the southwest of China,which has a high TB burden within the population.Methods MTB isolates were obtained from patients with active pulmonary tuberculosis at the TB dispensary and Chest hospital in Chongqing city between June 2003 and June 2006.Proportion methods were used to test the sensitivity to INH,RFP,SM and EMB of cultured MTB.A total of 100 MTB isolates were also randomly selected for analysis of the molecular mutation spectrum of katG by DNA sequencing.Results Totally 1 089 MTB isolates that completed positive sputum cultures and evaluated for their sensitivity to the four first-line drugs among 2 777 patients with TB.The prevalence of DR-TB and multi-drug resistant tuberculosis(MDR-TB)were 27.7%(302/1089)and 7.3%(79/1089),respectively.The resistance to anti-TB drugs was found to be highest for SM(16·3%)and INH(14·0%).There was also a significant increase in the prevalence of resistance to RFP and EMB(P<0.01),and an increase in MDR-TB between June 2003 and June 2004 and between July 2005 and June 2006.The total mutation rate of katG315 was 75·5%(37/49)in INH-resistant MTB,and mutation sites included S315T,S315N and S315I with mutation rates of 81·1%(30/37),13·5%(5/37)and 5·4%(2/37),respectively. No katG315 mutants were found in any of the 48 INH-sensitive MTB.Our preliminary diagnostic results suggest that mutations in katG315 may potentially serve as molecular markers that can be used to diagnose the resistance to anti-TB drug of INH.Conclusion In the Chongqing,DR-TB and MDR-TB are increasing,and are becoming key problems for tuberculosis control.The use of katG315 mutations as potential molecule markers for drug resistance to INH may help improve patient treatment and decrease the spread of the disease. 展开更多
关键词 流行病学特征 中国重庆 结核病 耐药 敏感性评价 抗结核药物 分子标志物 结核分枝杆菌
下载PDF
Anti TB drug resistance in Tanga,Tanzania:a cross sectional facility base prevalence among pulmonary TB patients
7
作者 Ha Abubakar S.Hoza Sayoki G.M.Mfinanga Brigitte Knig 《Asian Pacific Journal of Tropical Medicine》 SCIE CAS 2015年第11期887-893,共7页
Objective:To determine the prevalence and risk factors associated with drug resistance tuberculosis(TB) at facility-base level in Tanga,Tanzania.Methods:A total of 79 Mycobacterium tuberculosis(MTB) isolates included ... Objective:To determine the prevalence and risk factors associated with drug resistance tuberculosis(TB) at facility-base level in Tanga,Tanzania.Methods:A total of 79 Mycobacterium tuberculosis(MTB) isolates included in the study were collected from among372(312 new and 60 previously treated) TB suspects self referred to four TB clinics during a prospective study conducted from November 2012 to January 2013.Culture and drug susceptibility test of the isolates was performed at the institute of medical microbiology and epidemiology of infectious diseases,University hospital,Leipzig,Germany.Data on the patient's characteristics were obtained from structured questionnaire administered to the patients who gave informed verbal consent.Unadjusted bivariate logistic regression analysis was performed to assess the risk factors for drug resistant-TB.The significance level was determined at P<0.05.Results:The overall proportions of any drug resistance and MDRTB were 12.7%and 6.3%respectively.The prevalence of any drug resistance and MDRTB among new cases were 11.4%and 4.3%respectively,whereas among previously treated cases was 22.2%respectively.Previously treated patients were more likely to develop anti-TB drug resistance.There was no association between anti-TB drug resistances(including MDRTB) with the risk factors analysed.Conclusions:High proportions of anti TB drug resistance among new and previously treated cases observed in this study suggest that,additional efforts still need to be done in identifying individual cases at facility base level for improved TB control programmes and drug resistance survey should continuously be monitored in the country. 展开更多
关键词 pulmonary tuberculosis PREVALENCE drug resistance
下载PDF
2015—2022年天水市肺结核患者耐药情况及利福平耐药特征分析
8
作者 李江红 雷彩英 +5 位作者 颜淑萍 刘晓岚 杨琪 王热勤 刘芳 杨枢敏 《中国防痨杂志》 CAS CSCD 北大核心 2024年第3期340-348,共9页
目的:分析2015—2022年甘肃省天水市肺结核患者耐药情况及利福平耐药特征,为优化耐药结核病卫生政策提供科学依据。方法:采用回顾性研究方法,从“中国疾病预防控制信息系统”子系统“结核病管理信息系统”中收集2015—2022年天水市肺结... 目的:分析2015—2022年甘肃省天水市肺结核患者耐药情况及利福平耐药特征,为优化耐药结核病卫生政策提供科学依据。方法:采用回顾性研究方法,从“中国疾病预防控制信息系统”子系统“结核病管理信息系统”中收集2015—2022年天水市肺结核患者实验室检测结果、耐药筛查和耐药结核病诊断信息等资料,分析患者病原学阳性率、药物敏感性试验结果和耐药诊断时间等。结果:2015—2022年,天水市共登记活动性肺结核患者8458例,除外结核性胸膜炎的肺结核患者为7895例,病原学阳性率为28.32%(2236/7895),且从2015年的11.33%(177/1562)上升至2022年的61.30%(236/385),呈明显上升趋势(χ_(趋势)^(2)=1014.480,P=0.000);天水市应耐药筛查肺结核患者2360例,实际耐药筛查率为85.00%(2006/2360),从2015年的54.80%(97/177)上升至2022年的93.39%(240/257),呈明显上升趋势(χ_(趋势)^(2)=397.292,P=0.000);天水市耐药检出率为98.90%(1984/2006),利福平耐药检出率为15.73%(312/1984),从2015年的10.42%(10/96)上升至2017年的28.57%(62/217),再下降至2022年的11.34%(27/238),呈先上升后下降趋势(χ_(趋势)^(2)=27.248,P=0.000)。312例利福平耐药患者中,男性[198例(63.46%)]多于女性[114例(36.54%)];年龄相对集中在20~29岁[85例(27.24%)]和40~49岁[66例(21.15%)],且老年患者(60~83岁)比例从2016年的9.52%(2/21)上升至2022年的25.93%(7/27),呈明显上升趋势(χ_(趋势)^(2)=4.801,P=0.028);职业以农民为主[213例(68.27%)];痰涂片结果以涂阳患者居多[215例(68.91%)],但痰涂片阳性率从2015年的100.00%(10/10)下降至2022年的59.26%(16/27),呈下降趋势(χ_(趋势)^(2)=17.664,P=0.000)。耐药谱前3位依次为利福平+异烟肼+乙胺丁醇[26.92%(84/312)]、利福平[26.28%(82/312)]和利福平+异烟肼[23.40%(73/312)]。耐药患者诊断时间中位数(四分位数)从2016年的145(91,196)d逐年下降至2019年的21(12,39)d。结论:2015—2022年天水市肺结核患者病原学阳性率和耐药筛查率均呈逐年上升趋势,利福平耐药检出率波动较大,耐药诊断时间明显缩短,建议加大老年肺结核患者利福平耐药筛查力度,以减少耐药肺结核的传播。 展开更多
关键词 结核 结核 抗多种药物性 卫生服务研究 人群监测 天水市
下载PDF
青藏高原肺结核合并念珠菌感染患者的病原菌分布特点及耐药率分析
9
作者 史生辉 石飞 +2 位作者 雷琼 王亚峰 吴雪花 《药学实践与服务》 CAS 2024年第6期260-262,272,共4页
目的研究青藏高原肺结核患者中机会性念珠菌病原学分布特点及耐药情况。方法分析2020年3月1日至2020年12月31日青海省第四人民医院3012例住院肺结核患者,收集痰标本,采用VITEK-32-YBC全自动细菌分析系统进行念珠菌鉴定,并对检出的念珠... 目的研究青藏高原肺结核患者中机会性念珠菌病原学分布特点及耐药情况。方法分析2020年3月1日至2020年12月31日青海省第四人民医院3012例住院肺结核患者,收集痰标本,采用VITEK-32-YBC全自动细菌分析系统进行念珠菌鉴定,并对检出的念珠菌进行药敏试验。结果在本次调查的3012例肺结核患者中,合并念珠菌感染的肺结核患者有283例,占9.40%。其中,念珠菌类型又以白念珠菌为主,占总数的79.86%。结论青藏高原地区肺结核合并念珠菌感染的患病率较高。因此,选择抗菌药物要根据患者的情况综合分析,以此来选择最佳、最有效的药物治疗方法。 展开更多
关键词 肺结核 念珠菌 病原学 耐药率
下载PDF
GeneXpert MTB/RIF检测技术在新疆结核病防治规划中的应用效果
10
作者 古丽娜·巴德尔汗 刘年强 +7 位作者 伊帕尔·艾海提 王乐 王森路 祖力卡提阿衣·阿布都拉 王明哲 张静 王新旗 毕洪波 《中国防痨杂志》 CAS CSCD 北大核心 2024年第2期173-177,共5页
目的:探索在施行结核病防治“新疆模式”中,全面应用GeneXpert MTB/RIF(简称“GeneXpert”)检测发现肺结核及利福平耐药肺结核的效果。方法:从“中国疾病预防控制信息系统”的子系统“结核病管理信息系统”中,收集2017—2020年新疆维吾... 目的:探索在施行结核病防治“新疆模式”中,全面应用GeneXpert MTB/RIF(简称“GeneXpert”)检测发现肺结核及利福平耐药肺结核的效果。方法:从“中国疾病预防控制信息系统”的子系统“结核病管理信息系统”中,收集2017—2020年新疆维吾尔自治区(简称“新疆”)肺结核登记数据,对全面应用GeneXpert检测的效果进行分析,评价2017-2020年肺结核病原学阳性率、利福平耐药检测率、利福平耐药患者发现水平的变化。结果:GeneXpert设备覆盖率、GeneXpert检测率、病原学阳性率分别从2017年的20.00%(22/110)、0.32%(126/39 261)和20.17%(7919/39 261)提高到2020年的100.00%(110/110)、75.16%(19 610/26 090)和57.94%(15 116/26 090),差异均有统计学意义(χ^(2)=40.705,P<0.001;χ^(2)=174.087,P<0.001;χ^(2)=47.569,P<0.001)。病原学阳性患者数从2017年的7919例提高到2020年的15 116例,仅GeneXpert检测阳性患者数从2017年的6例提高到2020年的7194例,所占比例从0.08%(6/7919)提高到47.59%(7194/15 116),差异有统计学意义(χ^(2)=83.824,P<0.001)。病原学阳性肺结核患者利福平耐药筛查率和GeneXpert耐药检测率分别从2017年的44.49%(3523/7919)和1.85%(65/3523)提高到2020年的99.79%(15 084/15 116)和96.13%(14 501/15 084),差异均有统计学意义(χ^(2)=133.333,P<0.001;χ^(2)=250.893,P<0.001)。结论:GeneXpert检测技术的应用,可以明显提升病原学阳性和利福平耐药肺结核的发现水平,有利于新疆结核病疫情的快速下降。 展开更多
关键词 结核 利福平 抗药性 核酸扩增技术 对比研究
下载PDF
肺结核继发其他病原菌肺部感染的病原菌特征及耐药性分析
11
作者 吴良宁 林群英 林国盛 《当代医学》 2024年第7期123-126,共4页
目的分析肺结核继发其他病原菌肺部感染的病原菌特征及耐药性。方法2019年1月至2021年5月莆田学院附属医院收治的320例肺结核继发其他病原学肺部感染患者作为研究对象,取所有患者的痰液或肺泡灌洗液样本进行痰培养,并展开药敏试验。结果... 目的分析肺结核继发其他病原菌肺部感染的病原菌特征及耐药性。方法2019年1月至2021年5月莆田学院附属医院收治的320例肺结核继发其他病原学肺部感染患者作为研究对象,取所有患者的痰液或肺泡灌洗液样本进行痰培养,并展开药敏试验。结果320例患者共分离96株病原菌,病原菌分布为革兰阴性菌占比58.33%、真菌占比28.13%和革兰阳性菌占比13.54%。革兰阳性菌以金黄色葡萄球菌和表皮葡萄球菌最常见,对哌拉西林、庆大霉素、左氧氟沙星的耐药性最高,对多粘菌素B、美罗培南和亚胺培南的耐药性低;革兰阴性菌以肺炎克雷伯菌、铜绿假单胞菌、鲍曼不动杆菌和大肠埃希菌最常见,对青霉素、苯唑西林、红霉素的耐药性最高,对万古霉素、利奈唑胺和替加环素的耐药性低;真菌以白假丝孝母菌最常见,对酮康唑、氟康唑的耐药性最高,对两性霉素和伏立康唑的耐药性低。结论导致肺结核继发肺部感染的病原菌种类多,需开展病原学检查,并以药敏试验结果为参考合理的选择药物,以确保临床治疗有效性及用药安全性。 展开更多
关键词 肺结核 肺部感染 病原菌 耐药性
下载PDF
苦黄注射液预防抗结核药物导致的药物性肝损伤患者疗效研究
12
作者 任浩 刘力伟 +3 位作者 施维 刘波 吴于青 吕芹 《实用肝脏病杂志》 CAS 2024年第1期56-59,共4页
目的本研究观察了应用苦黄注射液预防抗结核药物诱发药物性肝损伤(DILI)的作用,以避免不合理的抗痨中断治疗。方法2022年3月~2022年11月我院收治的97例肺结核患者,被随机分为试验组50例和对照组47例。所有患者均接受标准的2HREZ/4HR抗... 目的本研究观察了应用苦黄注射液预防抗结核药物诱发药物性肝损伤(DILI)的作用,以避免不合理的抗痨中断治疗。方法2022年3月~2022年11月我院收治的97例肺结核患者,被随机分为试验组50例和对照组47例。所有患者均接受标准的2HREZ/4HR抗结核治疗,试验组在此治疗的基础上加用苦黄注射液治疗8周。采用ELISA法检测血清白介素6(IL-6)和肿瘤坏死因子-α(TNF-α),采用放射免疫法检测血清血红素加氧酶(HO-1)和超氧化物歧化酶(SOD)水平。结果在治疗4周末,试验适应性肝损伤和DILI发生率分别为6.0%和2.0%,显著低于对照组的17.0%和8.5%(P<0.05),在治疗8周末,试验组适应性肝损伤和DILI发生率分别为6.0%和4.0%,显著低于对照组的21.3%和17.0%(P<0.05);在治疗8周末,试验组血清ALT、AST和TBIL水平分别为(28.4±23.4)U/L、(30.8±18.7)U/L和(12.9±7.3)μmol/L,显著低于对照组【分别为(53.1±33.1)U/L、(52.5±37.7)U/L和(20.1±10.9)μmol/L,P<0.05】;试验组血清HO-1和SOD水平分别为(200.3±14.0)U/L和(418.0±18.7)U/L,显著高于对照组【分别为(128.8±21.4)U/L和(318.0±15.1)U/L,P<0.05】,而血清IL-6和TNF-α水平分别为(11.4±1.9)ng/L和(9.3±1.8)ng/L,显著低于对照组【分别为(17.5±4.0)ng/L和(14.5±3.0)ng/L,P<0.05】。结论在抗痨开始时应用苦黄能够显著降低DILI的发生,尽可能地维持标准化抗结核治疗,且安全性良好。 展开更多
关键词 药物性肝损伤 肺结核 抗结核药物 适应现象 苦黄 预防
下载PDF
广州市“十二五”与“十三五”期间利福平耐药肺结核患者发现与治疗情况分析
13
作者 杜雨华 冯亚娟 +2 位作者 雷宇 赖铿 何蔚云 《中国防痨杂志》 CAS CSCD 北大核心 2024年第6期678-686,共9页
目的:分析广州市“十二五”与“十三五”结核病防治规划期间利福平耐药肺结核(RR-PTB)患者发现与治疗情况,为进一步制定本地区RR-PTB防治规划提供科学依据。方法:通过“中国疾病预防控制信息系统”子系统“结核病信息管理系统”,按照登... 目的:分析广州市“十二五”与“十三五”结核病防治规划期间利福平耐药肺结核(RR-PTB)患者发现与治疗情况,为进一步制定本地区RR-PTB防治规划提供科学依据。方法:通过“中国疾病预防控制信息系统”子系统“结核病信息管理系统”,按照登记时间导出2011年1月1日至2020年12月31日,即“十二五”(2011—2015年)和“十三五”(2016—2020年)规划期间广州市登记的肺结核患者耐药病案数据(包括性别、年龄、民族、职业、户籍、耐药类型、治疗分类等相关信息),筛选出利福平耐药患者病案,分析患者登记、人群特征、耐药筛查和治疗转归情况。结果:2011—2020年,RR-PTB患者年均登记率为0.71/10万(1152/16286.08万),从2011年的0.31/10万(42/1346.32万)上升至2015年的0.38/10万(60/1594.95万)和2020年的0.97/10万(182/1874.03万),呈逐年上升趋势(χ_(趋势)^(2)=256.395,P<0.001)。其中,“十二五”期间年均登记率为0.34/10万(250/7358.06万),不同年份登记率的差异无统计学意义(χ_(趋势)^(2)=4.674,P=0.322);“十三五”期间年均登记率为1.01/10万(902/8928.02万),不同年份登记率的差异有统计学意义(χ_(趋势)^(2)=38.439,P<0.001)。1152例患者中,以男性(851例,73.87%)、25~34岁青壮年(257例,22.31%)和家政家务及待业(364例,31.60%)为主;流动人口、初治、RR-PTB(除异烟肼耐药)、广泛耐药肺结核比例分别从“十二五”的8.80%(22/250)、11.20%(28/250)、0.00%(0/250)和0.00%(0/250)上升到“十三五”的54.43%(491/902)、37.14%(335/902)、19.84%(179/902)和0.78%(7/902),差异均有统计学意义(χ^(2)=91.370、298.740、97.915、34.096,P值均<0.001)。广州市耐药肺结核高危人群筛查率由2017年的60.91%(148/243)上升至2020年的98.95%(568/574),新发/初治病原学阳性肺结核耐药应筛查率由2018年的83.93%(1410/1680)提高到2020年的94.99%(3222/3392),差异均有统计学意义(χ_(趋势)^(2)=425.043、269.670,P值均<0.001)。纳入治疗、完成治疗和治疗成功的患者比例分别从“十二五”的81.20%(203/250)、2.46%(5/203)和45.81%(93/203)提高到“十三五”的91.02%(821/902)、33.62%(276/821)和67.48%(554/821),治疗失败患者比例从17.73%(36/203)降低至2.68%(22/821),差异均有统计学意义(χ^(2)=19.112、86.809、46.636、58.572,P值均<0.001)。结论:在“十二五”与“十三五”规划期间,广州市RR-PTB的防治工作取得了显著的成效。下一步工作中需继续坚持政府主导、多部门合作和全社会共同参与的原则,切实落实结核病防治规划要求,加强结核病防治服务体系建设。 展开更多
关键词 结核 利福平 抗药性 微生物 登记 治疗结果
下载PDF
贝达喹啉联合背景方案治疗耐药肺结核的疗效
14
作者 冯治宇 邝浩斌 +3 位作者 汪敏 张宏 袁园 黄显林 《实用中西医结合临床》 2024年第1期6-9,共4页
目的:探讨贝达喹啉联合背景方案治疗耐药肺结核的疗效。方法:回顾性选择2022年1月至2023年1月广东省广州市胸科医院收治的159例耐药肺结核患者,按随机对照原则分组。对照组(80例)接受常规背景方案治疗,研究组(79例)在其基础上联合贝达... 目的:探讨贝达喹啉联合背景方案治疗耐药肺结核的疗效。方法:回顾性选择2022年1月至2023年1月广东省广州市胸科医院收治的159例耐药肺结核患者,按随机对照原则分组。对照组(80例)接受常规背景方案治疗,研究组(79例)在其基础上联合贝达喹啉治疗。于6个月后评估两组病灶吸收率、痰菌转阴率及空洞闭合率,对比两组治疗前后血清肝功能指标、心电图QTc变化,统计两组不良反应发生率。结果:研究组病灶吸收率、痰菌转阴率及空洞闭合率均较对照组高(P<0.05)。两组治疗后丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)水平升高(P<0.05);研究组治疗后ALT、AST水平与对照组相比,差异无统计学意义(P>0.05)。两组治疗后QTcF值升高,心率降低(P<0.05)。且研究组治疗后QTcF值比对照组高,心率比对照组低(P<0.05)。两组转氨酶升高、白细胞减少及胃肠道反应发生率对比,差异无统计学意义(P>0.05);研究组QT间期延长发生率显著高于对照组(P<0.05)。结论:贝达喹啉联合背景方案治疗耐药肺结核的疗效较佳,未引起肝功能指标异常,但QT间期延长发生率较高。 展开更多
关键词 耐药肺结核 贝达喹啉 背景方案 疗效 肝功能
下载PDF
观察肺结核患者采用水飞蓟宾胶囊预防抗结核药物肝损害的临床效果
15
作者 高阳 《中国实用医药》 2024年第2期106-109,共4页
目的 探讨对肺结核患者采用水飞蓟宾胶囊预防抗结核药物肝损害的临床效果。方法 100例肺结核患者作为研究对象,根据入院治疗时间顺序分为实验组和对照组,各50例。对照组通过常规的抗结核方式治疗,实验组以对照组为基准增加水飞蓟宾胶囊... 目的 探讨对肺结核患者采用水飞蓟宾胶囊预防抗结核药物肝损害的临床效果。方法 100例肺结核患者作为研究对象,根据入院治疗时间顺序分为实验组和对照组,各50例。对照组通过常规的抗结核方式治疗,实验组以对照组为基准增加水飞蓟宾胶囊治疗。比较两组患者的肝功能指标[谷氨酰转肽酶(GGT)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBil)],不良反应发生情况,治疗效果,治疗满意度。结果 治疗后,实验组患者的ALT、AST、GGT、TBil水平显著低于治疗前,对照组患者的ALT、AST、GGT、TBil水平均高于治疗前,且实验组患者的ALT(34.65±6.23)U/L、AST(37.25±8.26)U/L、GGT(7.29±1.69)U/L、TBil(15.27±4.79)μmol/L均低于对照组的(44.76±7.15)U/L、(46.39±9.50)U/L、(12.47±3.01)U/L、(22.31±6.05)μmol/L,经统计学软件分析得出(P<0.05)。实验组不良反应发生率(14%)与对照组(18%)比较差异不大,经统计学软件分析得出(P>0.05)。治疗后,实验组总有效率(86%)高于对照组(68%),经统计学软件分析得出(P<0.05)。实验组治疗满意度(94%)高于对照组(76%),经统计学软件分析得出(P<0.05)。结论 水飞蓟宾胶囊对肺结核患者抗结核药物肝损害具有积极的预防作用,能减少不良反应的发生,可增强患者的治疗效果并提高患者的满意度,值得在临床上推广。 展开更多
关键词 肺结核 水飞蓟宾胶囊 抗结核药物 肝损害
下载PDF
白细胞减少的准广泛耐药肺结核患者使用康替唑胺的临床实践分析
16
作者 李祥 张宏 邝浩斌 《抗感染药学》 2024年第2期123-125,130,共4页
目的:分析1例白细胞减少的准广泛耐药(pre-extensively drug-resistant,pre-XDR)肺结核患者使用康替唑胺的临床实践过程,为类似耐药结核病患者探索有效的抗结核治疗方案提供参考。方法与结果:患者4个月前被确诊为pre-XDR肺结核,并予贝... 目的:分析1例白细胞减少的准广泛耐药(pre-extensively drug-resistant,pre-XDR)肺结核患者使用康替唑胺的临床实践过程,为类似耐药结核病患者探索有效的抗结核治疗方案提供参考。方法与结果:患者4个月前被确诊为pre-XDR肺结核,并予贝达喹啉+利奈唑胺+氯法齐明+环丝氨酸+丙硫异烟胺抗结核治疗;治疗20 d后,反复出现头晕、多梦、易醒等症状;1 d前,再次出现难以入睡症状并伴烦热感和右膝关节疼痛,遂入院治疗;住院期间,患者多次出现白细胞减少情况,考虑为利奈唑胺骨髓抑制所致,服用利可君片亦不能改善,临床在斟酌后决定停用利奈唑胺,改用康替唑胺,之后白细胞水平果然明显恢复;此外,患者反复出现的难以入睡症状考虑为环丝氨酸的中枢神经毒性反应,而住院期间出现的Q-T间期延长则考虑是贝达喹啉所致,遂决定停用此二药;最后,患者的抗结核方案被调整为康替唑胺+氯法齐明+阿米卡星+乙胺丁醇+丙硫异烟胺,之后患者未再出现不适症状和指标异常。结论:pre-XDR肺结核属于较为难治的疾病,治疗时用药较多且复杂,很容易发生药物不良反应,并且部分药物不良反应可能会导致严重不良后果;对此,临床应采取积极干预措施,并及时调整抗结核治疗方案,以保证患者的用药安全和治疗效果。 展开更多
关键词 康替唑胺 准广泛耐药肺结核 抗结核治疗 白细胞减少 利奈唑胺 环丝氨酸 贝达喹啉
下载PDF
2011—2020年北京市怀柔区耐药结核病高危人群利福平耐药筛查情况分析
17
作者 崔国强 《黑龙江医学》 2024年第5期592-594,共3页
目的:通过筛查耐药结核病高危人群,了解北京市怀柔区耐药结核病高危人群利福平耐药情况。方法:统计2011—2020年登记管理的肺结核患者中耐药结核病高危人群筛查情况,包括筛查对象、结核菌培养及药敏试验,对耐药高危人群利福平耐药情况... 目的:通过筛查耐药结核病高危人群,了解北京市怀柔区耐药结核病高危人群利福平耐药情况。方法:统计2011—2020年登记管理的肺结核患者中耐药结核病高危人群筛查情况,包括筛查对象、结核菌培养及药敏试验,对耐药高危人群利福平耐药情况进行分析。结果:2011—2020年北京市怀柔区共登记利福平耐药高危人群130例,完成耐药筛查130例,筛查率为100.00%。实验室污染率为3.08%,其中,涂阳培阴率为34.62%,主要体现在治疗2个月及以上的痰涂片或培养仍为阳性的初治患者中;耐药结核病高危人群培养阳性81例,菌种鉴定为结核分枝杆菌75例,检出利福平耐药23例,检出率为30.67%,明显高于与同期初治培养阳性的肺结核患者利福平耐药检率的3.33%,差异有统计学意义(χ^(2)=40.82,P<0.05)。结论:北京市怀柔区积极开展监测,使利福平耐药结核病能够得到有效的管理和医治,做到早发现、早治疗,避免因贫致病、因病返贫,更重要的是能够有效遏制利福平耐药肺结核的传播风险,减少对人们健康的危害。 展开更多
关键词 肺结核 高危人群 耐药 利福平
下载PDF
基于全基因组测序的四川省22例复发肺结核患者感染模式及耐药情况分析
18
作者 雷卉 张书 +7 位作者 李婷 高媛 刘双 陈闯 夏岚 王为娜 高文凤 何金戈 《中国防痨杂志》 CAS CSCD 北大核心 2024年第6期641-647,共7页
目的:分析复发肺结核患者感染模式和耐药信息,为结核病患者治疗及防控提供科学依据。方法:采用前瞻性研究方法,参照入组标准从四川省峨眉山市、绵阳市涪城区和江油市3个耐药监测点收集2012—2021年肺结核患者分枝杆菌培养阳性菌株2207株... 目的:分析复发肺结核患者感染模式和耐药信息,为结核病患者治疗及防控提供科学依据。方法:采用前瞻性研究方法,参照入组标准从四川省峨眉山市、绵阳市涪城区和江油市3个耐药监测点收集2012—2021年肺结核患者分枝杆菌培养阳性菌株2207株,剔除286株重复菌株后与中国疾病预防控制中心结核病信息管理系统进行比对,排除18例发病间隔<12个月的患者后,对34例有2次及以上就诊情况患者菌株进行复苏、DNA提取、全基因组测序,分析复发患者结核感染模式和耐药情况。结果:排除11例某一配对菌株传代培养失败及1例全基因组测序结果为非结核分枝杆菌的患者后,最终纳入22例复发肺结核患者进行分析。其中,14例(63.6%)患者为内源性复燃,本地患者、发病间隔、初始感染菌株为Lineage 2谱系、耐药、耐多药、异烟肼耐药患者分别为13例(92.9%)、18.00(13.50,24.50)个月、10例(71.4%)、6例(42.9%)、2例(14.3%)、5例(35.7%),2例获得性耐药,1例乙硫异烟胺耐药性消失;8例(36.4%)患者为外源性再感染,其相应数据分别为4例(4/8)、14.50(13.25,16.75)个月、4例(4/8)、5例(5/8)、3例(3/8)、5例(5/8),且两次感染耐药类型均不同。结论:四川省作为结核病高负担地区,复发仍以内源性复燃为主,但耐药严重的外源性再感染也应引起重视,应积极关注这类患者的治疗情况,制定个体化用药方案,减少结核病复发。 展开更多
关键词 结核 复发 全基因组测序 结核 抗多种药物性 流行病学研究
下载PDF
耐药肺结核患者密切接触者结核分枝杆菌潜伏感染危险因素分析
19
作者 叶新春 刘赛朵 +7 位作者 程芳 蒋贤高 宁洪叶 吴正兴 周月影 邱超超 潘宁 施伎蝉 《中国防痨杂志》 CAS CSCD 北大核心 2024年第5期525-530,共6页
目的:探究耐药肺结核患者密切接触者结核分枝杆菌潜伏感染(latent tuberculosis infection,LTBI)情况及危险因素。方法:采用前瞻性研究方法,选取2020年7月至2022年1月于温州市中心医院收治的154例耐药肺结核(包括单耐利福平肺结核、耐... 目的:探究耐药肺结核患者密切接触者结核分枝杆菌潜伏感染(latent tuberculosis infection,LTBI)情况及危险因素。方法:采用前瞻性研究方法,选取2020年7月至2022年1月于温州市中心医院收治的154例耐药肺结核(包括单耐利福平肺结核、耐多药肺结核)患者的306名密切接触者作为研究对象。收集研究对象社会人口学特征、卡介苗接种史、疾病史,以及与指示病例的接触情况等信息;并进行HIV抗体筛查、胸部CT扫描、结核感染T细胞斑点试验和(或)结核菌素皮肤试验(PPD试验)等。调查研究对象LTBI情况,并采用logistic回归模型分析其发生LTBI的影响因素。结果:研究对象结核分枝杆菌潜伏感染率为18.6%(57/306)。多因素分析结果表明,年龄≥40岁、女性、体力劳动者、指示病例为复治患者,以及指示病例有咳嗽、咳痰等临床症状的密切接触者发生LTBI的风险更高[OR(95%CI)值分别为6.501(1.371~30.827)、2.961(1.472~5.956)、2.716(1.368~5.391)、3.100(1.278~7.521)、3.065(1.336~7.031)];而家庭月收入≥5000元是密切接触者发生LTBI的保护因素[OR(95%CI)=0.308(0.156~0.607)]。结论:耐药肺结核患者密切接触者结核分枝杆菌潜伏感染率较高,高龄、女性、体力劳动者、低收入,以及与复治耐药肺结核患者和具有咳嗽、咳痰等临床症状耐药肺结核患者的密切接触者是发生LTBI的高危人群。 展开更多
关键词 结核 抗药性 细菌 接触者追踪 感染 因素分析 统计学
下载PDF
高效液相色谱-质谱联用法测定血浆中异烟肼及其代谢物浓度的研究
20
作者 葛菲 朱慧 +2 位作者 程凯 陆宇 徐建 《中国防痨杂志》 CAS CSCD 北大核心 2024年第5期549-556,共8页
目的:建立高效液相色谱-质谱联用法(HPLC-MS/MS)同时测定肺结核患者血浆中异烟肼及其代谢物乙酰肼和肼的浓度的方法。方法:收集首都医科大学附属北京胸科医院确诊的104例肺结核患者(均接受规范抗结核治疗,服用异烟肼的剂量为1次/d,每次3... 目的:建立高效液相色谱-质谱联用法(HPLC-MS/MS)同时测定肺结核患者血浆中异烟肼及其代谢物乙酰肼和肼的浓度的方法。方法:收集首都医科大学附属北京胸科医院确诊的104例肺结核患者(均接受规范抗结核治疗,服用异烟肼的剂量为1次/d,每次300~500 mg,于服药后2 h采集静脉血)的血浆样本作为研究样本。血浆样品经甲醇沉淀蛋白后,以异烟肼-D4为内标,以对甲基苯甲醛作为衍生化试剂,对待测物进行衍生化处理,采用InfinityLab Poroshell 120 HILIC-Z色谱柱(100 mm×2.1 mm,2.7μm)分离,二元洗脱系统(A相为含0.1%甲酸和5 mmol甲酸铵的水溶液;B相为乙腈)进行梯度洗脱,柱温30℃,流速0.4 ml/min;采用电喷雾电离正离子模式检测,多反应监测模式扫描,运行时间为8 min。结果:本测定方法不受血浆中内源性物质干扰,异烟肼、乙酰肼、肼分别在50~6000、25~3000、1~120 ng/ml范围内线性良好[决定系数(R^(2))均>0.99];日内和日间精密度<15%;准确度绝对值<15%;提取回收率均>85%;基质效应在85%~115%;稳定性良好。应用该方法检测104例肺结核患者的异烟肼、乙酰肼及肼的浓度,分别为(2402.33±1248.57)ng/ml、(1902.51±596.82)ng/ml、(26.50±17.13)ng/ml。结论:本研究建立的HPLC-MS/MS法操作简便、分析快速、专属性强、敏感度高,可应用于异烟肼及其代谢物乙酰肼和肼在肺结核患者中的治疗药物浓度监测。 展开更多
关键词 结核 异烟肼 液相色谱-质谱法 药物监测
下载PDF
上一页 1 2 99 下一页 到第
使用帮助 返回顶部