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目的:探讨骨关节结核耐药类型的变化,为临床合理用药提供参考。方法:取2004–2013年新疆维吾尔自治区胸科医院收集的骨关节结核患者标本行结核分枝杆菌培养和药物敏感试验,分析其耐药类型和耐药率的变化,分析原因并提供有效的应对措施。结果:1158例标本中,592例结核分枝杆菌培养阳性,阳性率51.1%,其中耐药菌株254例,耐多药菌株75例,总耐药率42.9%,总耐多药率12.7%。各年份总耐药率呈上升趋势,利福平耐药率呈上升趋势,耐单药、耐多药呈上升趋势,耐药顺序为异烟肼>链霉素>利福平>乙胺丁醇。结论:骨关节结核总体耐药情况呈上升趋势,耐多药结核形势严峻,与不规律用药有关,需做好结核病防控及患者抗结核治疗的督导工作,对于耐多药结核者可给予个体化治疗。
Objective: To explore the change of drug resistance type of tuberculosis in bone and joint and to provide a reference for clinical rational drug use. Methods: Mycobacterium tuberculosis culture and drug susceptibility tests were collected from samples of patients with bone-and-joint tuberculosis collected from the Xinjiang Uygur Autonomous Region Chest Hospital from 2004 to 2013. The changes of drug resistance and drug resistance were analyzed to analyze the causes and provide effective responses Measures. Results: Of the 1158 specimens, 592 were positive for Mycobacterium tuberculosis, with a positive rate of 51.1%. Among them, 254 were resistant strains and 75 were multidrug resistant strains with a total resistance rate of 42.9% and a total resistance rate of 12.7%. The total drug resistance rate in each year showed an upward trend, and the drug resistance rate of rifampin showed an upward trend, and the resistance to single drug and multidrug-resistant drug increased with the sequence of isoniazid, streptomycin, rifampicin, ethambutol alcohol. Conclusion: The overall drug resistance of bone and joint tuberculosis is on the rise. The situation of MDR-TB is serious, which is related to the irregular drug use. It is necessary to supervise the prevention and control of tuberculosis and anti-TB treatment in patients. For MDR-TB patients, Treatment.