论文部分内容阅读
目的分析标准化疗方案治疗肺结核患者失败与耐药及其它相关因素的关系,探究标准化疗方案治疗失败的原因,为我国结核病控制以及耐药结核病控制提供参考。方法收集新发涂阳肺结核患者相关信息;纳入肺结核患者在治疗0、5月末收集痰标本进行痰涂片检查和分离培养,采用比例法进行药物敏感性测定,获得治愈和失败两组患者的耐药信息。结果男性患者的失败率低于女性患者(P<0.01)、年龄40~60岁、待业人员的患者失败率高于其它年龄职业患者(P<0.01),复治病例首次治疗持续时间≥8个月的失败率最高(26.50%)(P<0.01),治疗中出现漏服药患者的失败率高于规律用药者(P<0.01);治愈组登记时的单一耐药率、多耐药率、耐多药率均低于失败组(P<0.01)。结论女性、40~60岁、待业、复治病例首次治疗持续时间≥8个月、治疗中出现漏服药等是影响治疗失败的相关危险性因素;标准化疗方案治疗失败主要是由于肺结核患者对抗结核药物耐药特别是耐多药所致。
Objective To analyze the relationship between the failure of standard chemotherapy in treating patients with pulmonary tuberculosis and other related factors and to explore the reasons for the failure of standard chemotherapy regimens and provide references for the control of tuberculosis and the control of drug-resistant tuberculosis in China. Methods To collect the information about the new smear-positive pulmonary tuberculosis patients; to collect the sputum samples for sputum smear examination and isolation and culture of tuberculosis patients at the end of 0 and 5 months of treatment, and to determine the drug sensitivity by the proportion method to get the cured and failed patient’s resistance Drug information. Results The failure rate of males was lower than that of females (P <0.01). The age of 40-60 years old, the failure rate of unemployed people was higher than that of other age occupational patients (P <0.01), and the first treatment duration of rehospitalization was ≥8 (P0.05). The failure rate of the patients who missed the medication was higher than that of the regular drug users (P0.01). The single drug resistance rate, multi-drug resistance rate, MDR rates were lower than the failure group (P <0.01). Conclusions Female patients aged 40 to 60 years old, unemployed and retreatment cases for the first time duration of treatment ≥ 8 months, the treatment of missed medication is the risk factors that affect the failure of treatment; standard chemotherapy treatment failure is mainly due to tuberculosis patients against tuberculosis Drug resistance, especially due to multi-drug resistance.