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目的评价结核病耐药以后对肺结核统一化学治疗方案效果的影响,为结核病控制规划策略调整提供参考。方法通过回顾性调查方式收集2012—2013年间治疗管理的227例肺结核病人,依据抗结核药物敏感试验结果将其分为耐药组(95例)及敏感组(132例),对其治疗效果及影响因素进行比较分析。结果通过调查发现结核菌耐药组疗程结束后痰标本中结核分枝杆菌阴转率为74.7%、抗结核药物敏感组痰中结核菌阴转率为91.7%,其病人细菌学复发率分别为11.3%及3.31%。然后耐一种药者痰菌阴转率为87.0%;耐两种药及三种药者分别为71.4%和54.5%。结论肺结核病患者原发耐药,尤其是同时对多种抗结核药物耐药是导致化学药物治疗失败的重要原因,临床用药时应认真参考药敏试验结果进行合理判断,慎重选择。
Objective To evaluate the effect of tuberculosis chemotherapy on the efficacy of the unified chemotherapy regimen in tuberculosis and provide reference for the adjustment of tuberculosis control planning strategy. Methods A retrospective survey was conducted to collect 227 cases of pulmonary tuberculosis patients who were treated and managed between 2012 and 2013. The patients were divided into two groups: drug-resistant group (95 cases) and sensitive group (132 cases) according to the results of anti-TB drug susceptibility test. The influencing factors are compared and analyzed. Results The results showed that the negative conversion rate of Mycobacterium tuberculosis in sputum specimens was 74.7% at the end of TB treatment, the negative conversion rate of TB in sputum of anti-TB drug-sensitive group was 91.7%, and the bacteriological recurrence rates were 11.3% and 3.31% respectively. Then a drug-resistant sputum negative conversion rate was 87.0%; resistant to two drugs and three drugs were 71.4% and 54.5%. Conclusion The primary drug resistance of patients with pulmonary tuberculosis, especially at the same time a variety of anti-TB drug resistance is an important reason for the failure of chemical drug treatment, clinical medication should be carefully referred to the drug susceptibility test results to make a reasonable judgment, careful choice.