【摘要】：目的探討不同類型復(fù)治肺結(jié)核的耐藥情況,為臨床復(fù)治肺結(jié)核患者制定合理的化療方案提供科學(xué)依據(jù)。方法收集貴陽市肺科醫(yī)院2010年1月-2011年12月住院的復(fù)治肺結(jié)核患者進(jìn)行結(jié)核分枝桿菌培養(yǎng)、菌種鑒定和藥物敏感性檢測(異煙肼(INH)、利福平(RFP)、乙胺丁醇(EMB)、鏈霉素(SM),氧氟沙星(OFX)、卡那霉素(KM))。結(jié)果復(fù)治肺結(jié)核患者中耐藥共203例,其中初治失敗組80例,耐藥率39.41%,耐多藥率25.86%,治愈后復(fù)發(fā)組37例,其耐藥率18.23%,耐多藥率19.83%,不規(guī)則治療1個月以上組26例,其耐藥率12.81%,耐多藥率12.07%,多次治療失敗痰菌持續(xù)陽性組60例,耐藥率29.56%;耐多藥率42.24%。在耐多藥病例中以初治失敗和多次治療失敗痰菌持續(xù)陽性為主。結(jié)論不同類型復(fù)治肺結(jié)核因既往用藥史不同,其耐藥率及耐多藥率各異,不同類型復(fù)治肺結(jié)核不能都用標(biāo)準(zhǔn)復(fù)治方案,對于不同類型復(fù)治肺結(jié)核患者必須結(jié)合患者既往用藥史和藥敏試驗(yàn)結(jié)果綜合分析制定個體化方案,減少耐藥和耐多藥結(jié)核的發(fā)生。
[Abstract]:Objective to investigate the drug resistance of different types of retreated pulmonary tuberculosis and to provide scientific basis for the establishment of rational chemotherapy regimen for patients with recurrent pulmonary tuberculosis. Methods Mycobacterium tuberculosis was collected from patients with recurrent pulmonary tuberculosis hospitalized in Guiyang Pulmonary Hospital from January 2010 to December 2011. Identification of bacteria and determination of drug sensitivity (isoniazid (INH), rifampicin (RFP), (RFP), ethambutanol (EMB), streptomycin (SM), ofloxacin (OFX), kanamycin (KM). Results there were 203 cases of drug resistance in patients with recurrent pulmonary tuberculosis, including 80 cases of failure group, 39.41% of drug resistance rate, 25.86% of multi-drug resistance rate, 37 cases of relapsing group after cure, 18.23% of drug resistance rate, 19.83% of multi-drug resistance rate and 26 cases of irregular treatment group for more than one month. The drug resistance rate was 12.81% and the multi-drug resistance rate was 12.07%. In the group of continuous positive sputum bacteria, the drug resistance rate was 29.56, and the multidrug resistance rate was 42.24%. In multi-drug resistant cases, the failure of initial treatment and repeated treatment failed sputum bacteria were mainly positive. Conclusion the rates of drug resistance and multidrug resistance of different types of pulmonary tuberculosis are different due to the different history of drug use, and different types of pulmonary tuberculosis can not be treated with standard regimen. In order to reduce the incidence of drug resistance and multidrug resistance tuberculosis patients with different types of relapsed pulmonary tuberculosis must make a comprehensive analysis of the past drug use history and drug sensitivity test results.
【作者單位】： 貴陽市肺科醫(yī)院;
【分類號】：R521;R446.5

【參考文獻(xiàn)】

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