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目的调查北京市疑似耐多药肺结核(MDR-TB)患者中各种类型耐药患者的比例,对确诊的MDR-TB患者,进行国产药物组方化疗,掌握其不良反应和阶段性效果,从而探索适合北京市实际情况的MDR-TB控制策略。方法在疑似耐多药患者中通过一线抗结核药物药敏试验的方法发现MDR-TB患者;对确诊的MDR-TB患者,使用为每日方案6 E.Z.Lfx.Pto.Ak/12-18 E.Z.Lfx.Pto进行治疗。结果疑似MDR-TB患者中,对一线药物全敏感、单耐药、多耐药、耐多药的比例分别为44.7%、11.2%、7.0%和37.1%。从2008年4月到2009年4月,共37例纳入耐多药项目进行治疗。有29人治疗满6个月,6月末痰涂片阴转率为75.9%,痰培养阴转率为78.3%(18/23)。结论耐多药肺结核患者在使用国产二线抗结核药物18~24个月方案治疗的情况下,6月末痰菌阴转率达到75.0%,阶段性治疗效果较理想。
Objective To investigate the proportion of various types of drug-resistant patients in suspected MDR-TB patients in Beijing and to determine the adverse reactions and stage effects of domestic drug combination chemotherapy on the diagnosed MDR-TB patients Explore the MDR-TB control strategy suitable for the actual situation in Beijing. Methods MDR-TB patients were identified by first-line anti-TB drug susceptibility testing in suspected MDR-TB patients, and patients who were diagnosed with MDR-TB were challenged with the daily program 6 EZLfx.Pto.Ak / 12-18 EZLfx .Pto for treatment. Results In patients with suspected MDR-TB, the proportion of patients who were fully sensitive, single-drug resistant, multi-drug resistant and multidrug resistant to first-line drugs was 44.7%, 11.2%, 7.0% and 37.1% respectively. From April 2008 to April 2009, a total of 37 cases were included in the multidrug-resistant program for treatment. 29 were treated for 6 months, sputum smear negative conversion rate was 75.9% at the end of June, sputum culture negative conversion rate was 78.3% (18/23). Conclusions In the case of multidrug-resistant pulmonary tuberculosis patients treated with 18-24 months of second-line home-made anti-tuberculosis drugs, the sputum negative conversion rate reached 75.0% at the end of June and the phased treatment effect was better.