【摘要】：目的:為耐多藥結(jié)核病(MDR-TB)患者合理使用抗結(jié)核藥及減少藥品不良反應(yīng)(ADR)提供參考。方法:選取2012年2月-2015年5月我院結(jié)核病住院患者,按照疑似MDR-TB(202例)和確診MDR-TB(162例)分為兩組,進(jìn)行藥物組化療法,并依據(jù)患者病情選擇不同的治療管理方式,并觀察ADR發(fā)生情況。兩組患者的治療管理期均為18個(gè)月。結(jié)果:疑似MDR-TB組患者對(duì)一線藥物的耐藥率均≥26.24%,其中對(duì)異煙肼和利福平的耐藥率為40%左右;對(duì)二線藥物的耐藥率均≥4.95%,其中對(duì)丙硫異煙胺耐藥率最高,為46.04%;藥敏試驗(yàn)結(jié)果顯示,一線藥物全敏感為44.06%,單耐藥為14.36%,多耐藥為9.90%,耐多藥為31.68%;一、二線藥物全敏感為21.78%,單耐藥為24.75%,多耐藥為17.82%,耐多藥為32.67%,廣泛耐藥為2.97%。MDR-TB患者治療管理方案中,結(jié)防機(jī)構(gòu)治療占56.17%;轉(zhuǎn)診于�？漆t(yī)院治療占14.81%;未治療者占22.22%;其他因素導(dǎo)致改變治療方案或無法繼續(xù)治療占6.79%。確診MDR-TB患者較疑似MDR-TB患者二線方案診療的ADR發(fā)生率較高,組間比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。經(jīng)后期對(duì)癥治療均有所好轉(zhuǎn)。結(jié)論:對(duì)于MDR-TB患者根據(jù)病情可有效尋找合適的治療管理方案,提高療效,降低ADR發(fā)生率,控制結(jié)核桿菌的傳播與發(fā)展。
[Abstract]:Objective: to provide reference for the rational use of anti-tuberculosis drugs and the reduction of adverse drug reactions (ADR) in multi-drug resistant tuberculosis (MDR-TB) patients. Methods: the inpatients with tuberculosis in our hospital from February 2012 to May 2015 were divided into two groups according to suspected MDR-TB (202 cases) and confirmed MDR-TB (162 cases). The occurrence of ADR was observed. The treatment management period of both groups was 18 months. Results: the drug resistance rates of suspected MDR-TB group to first-line drugs were more than 26.24, in which isoniazid and rifampicin resistance rates were about 40%, and those to second-line drugs were more than 4.95, among which the highest drug resistance rate to propylthioisoniamin was 46.040.The results of drug sensitivity test showed that the drug resistance rate of all the patients in the suspected MDR-TB group was more than 26.24, and the resistance rate to isoniazid and rifampicin was about 40%. The total sensitivity of first-line drug was 44.06, single drug resistance was 14.366,multi-drug resistance was 9.90 and multidrug resistance was 31.68.The first, second-line drug sensitivity was 21.78, single drug resistance was 24.75cm, multi-drug resistance was 17.82, multi-drug resistance was 32.67, and extensive drug resistance was in the treatment management plan of 2.97%.MDR-TB patients. 56.17% of them were treated by preventive organization; 14.81% were treated by referral to specialized hospital; 22.2222% were treated without treatment; 6.79% were changed or unable to continue treatment due to other factors. The incidence of ADR in confirmed MDR-TB patients was higher than that in suspected MDR-TB patients, and the difference between groups was statistically significant (P0.05). The symptomatic treatment was improved at the later stage. Conclusion: according to the condition of MDR-TB patients, we can find suitable treatment management plan, improve the curative effect, reduce the incidence of ADR, and control the spread and development of Mycobacterium tuberculosis.
【作者單位】： 宜昌市第三人民醫(yī)院結(jié)核科;
【分類號(hào)】：R52

【相似文獻(xiàn)】

相關(guān)期刊論文 前10條

1 黃福平,陳健忠;耐多藥結(jié)核病耐藥原因分析[J];中國防癆雜志;2000年02期

2 馬偉路,羅智;耐藥和耐多藥結(jié)核病及其控制[J];臨床肺科雜志;2000年01期

3 于維琴;耐多藥結(jié)核病的處理[J];臨床肺科雜志;2000年03期

4 曾國武;78例耐多藥結(jié)核病臨床分析[J];醫(yī)學(xué)文選;2000年05期

5 何國鈞;新世紀(jì)耐多藥結(jié)核病分子生物學(xué)診斷的重要性[J];中華傳染病雜志;2001年06期

6 肖成志,李群輝,李拯民,傅瑜;耐多藥結(jié)核病的治療[J];臨床肺科雜志;2001年03期

7 全國結(jié)核病胸部疾病科研協(xié)作組;耐多藥結(jié)核病治療的研究方案[J];臨床肺科雜志;2001年03期

8 C.Conover,R.Ridzon,S.Valway,L.Schoenstadt,J.McAuley,I.Onorato,W.Paul,an investigative team ,王海東;美沙酮治療規(guī)程中耐多藥結(jié)核病的暴發(fā)[J];結(jié)核與肺部疾病雜志(中文版);2001年02期

9 陸強(qiáng),王樞傳;耐多藥結(jié)核病的研究進(jìn)展[J];天津藥學(xué);2002年01期

10 李一耕;我國耐多藥結(jié)核病研究的現(xiàn)狀與思考[J];新醫(yī)學(xué);2003年11期

相關(guān)會(huì)議論文 前10條

1 馬s，

本文編號(hào)：2236205