论文部分内容阅读
目的分析泰安市结核病防治院痰培养阳性肺结核患者的耐药状况。方法对2010年1月至2011年12月泰安市结核病防治院住院治疗的389例痰培养阳性肺结核患者的基本情况和对利福平(RFP)/异烟肼(INH)、链霉素(S)、乙胺丁醇(EMB)、卡那霉素(Km)、和对氨基水杨酸钠(PAS)6种抗结核药物的药敏情况、耐药类型和耐药谱。结果 389例痰培养阳性肺结核患者中,耐药的225例,总耐药率为57.84%。其中,初治患者的耐药率为54.67%,复治患者的耐药率67.00%;初治组患者主要耐药的药物为INH(25.95%)、S(25.95%)、PAS(20.42%),复治组患者主要为INH(44.00%)、RFP(34.00%)、S(30.00%)、EMB(31.00%),复治患者对INH、RFP、EMB的耐药率均高于初治患者(P<0.05)。对一种抗结核药耐药的有72例,耐药率为18.51%,以S、INH和PAS耐药为主;多耐药的患者102例,耐药率为26.22%,以S+INH组合耐药为主;MDR-TB患者有51例,耐药率为13.11%,以INH+RFP、RFP+INH+S、RFP+INH+S+EMB、RFP+INH+EMB+PAS这4种组合常见。结论泰安市结核病防治院痰培养阳性的肺结核患者耐药率较高,对一线抗结核药物INH、S、EMB、RFP耐药率较高,复治患者容易发生耐多药,耐药谱呈多样化和复杂化。
Objective To analyze the drug resistance status of sputum culture positive pulmonary tuberculosis patients in TB Hospital of Tai’an City. Methods The data of 389 sputum culture positive pulmonary tuberculosis patients hospitalized in TB prevention and treatment hospital in Tai’an from January 2010 to December 2011 were analyzed retrospectively. The data of patients with sputum positive pulmonary tuberculosis (RFP) / isoniazid (INH), streptomycin ), Ethambutol (EMB), kanamycin (Km) and sodium p-aminosalicylate (PAS). Results Of 389 sputum culture positive pulmonary tuberculosis patients, 225 cases were resistant, with a total resistance rate of 57.84%. Among them, the rate of drug resistance was 54.67% in newly diagnosed patients and 67.00% in retreatment patients. The major drug-resistant drugs were INH (25.95%), S (25.95%) and PAS (20.42% , The patients in retreatment group were mainly INH (44.00%), RFP (34.00%), S (30.00%) and EMB (31.00%). The resistance rates of INH, RFP and EMB in retreatment patients were higher than those in untreated patients (P <0.05). There were 72 cases resistant to one kind of antituberculosis drug, the rate of resistance was 18.51%, mainly resistant to S, INH and PAS; 102 cases were multidrug resistant with a resistance rate of 26.22% 51 were MDR-TB patients, and the drug resistance rate was 13.11%. Four kinds of MDR-TB patients were treated with INH + RFP, RFP + INH + S, RFP + INH + S + EMB, RFP + INH + EMB + PAS Combination of common. Conclusion TB patients with positive sputum culture in TB prevention and treatment hospital of Taian City have a higher rate of drug resistance and are more resistant to first-line anti-TB drugs INH, S, EMB and RFP, and are more susceptible to multi-drug and multi-drug resistance spectrum in retreatment patients And complex.