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结核病自古以来就威胁着人类的健康,每年导致约200万人死亡。特别是近年来,耐多药结核病、广泛耐药结核病以及结核分枝杆菌与人免疫缺陷病毒(HIV)共感染的出现,给结核病的临床治疗带来了新的困难。耐多药结核病是耐受2种抗结核病一线药物的结核病,广泛耐药结核病是在耐多药的基础上至少耐受3种二线药物的结核病。耐药结核病的蔓延已经成为全球性的公共卫生问题,据世界卫生组织(WHO)最新的2009年度报告,2007年全球新发结核病病例927万例,死亡175万例,现有的1 370万例活动性结核病患者中,耐多药者达50万。外排泵系统的泵出作用是导致结核分枝杆菌耐药的重要机制之一。本文综述了近年来国际上在结核分枝杆菌外排泵及其抑制剂方面的研究进展。
Tuberculosis has been a threat to human health since ancient times, killing about 2 million people every year. Especially in recent years, the emergence of multidrug-resistant tuberculosis (MDR-TB), XDR-TB and co-infection with Mycobacterium tuberculosis and human immunodeficiency virus (HIV) have brought new difficulties in the clinical treatment of tuberculosis. MDR-TB is a tuberculosis that is resistant to two first-line anti-tuberculosis drugs, which are resistant to at least three second-line drugs on a multi-drug resistant basis. The spread of drug-resistant TB has become a global public health issue. According to the latest 2009 annual report of the World Health Organization (WHO), there were 9.27 million new cases of tuberculosis in the world in 2007, with 1.75 million deaths and 13.7 million existing ones Active tuberculosis patients, MDR up to 500,000. The pump-out effect of efflux pump system is one of the important mechanisms leading to the drug resistance of Mycobacterium tuberculosis. This review summarizes the recent research progress on mycobacterium tuberculosis efflux pump and its inhibitors in the world.