目的探讨老年肺结核患者痰结核菌的耐药情况。方法采用ＢＡＣＴＥＣ法对１３４例老年痰菌阳性肺结核患者痰结核分支杆菌做耐药性检测。结果老年肺结核患者初始耐药率为３６８％，显著低于获得性耐药率的７５９％（Ｐ＜００１）；耐异烟肼（ＩＮＨ，Ｈ）、利福平（ＲＦＰ，Ｒ）、链霉素（ＳＭ，Ｓ）前者亦明显低于后者（Ｐ＜００１）。初治组耐２和３种药比例为６６％和５３％，与复治组的２２４％和２７７％相比差异有显著性（Ｐ＜００１）。至少耐异烟肼和利福平两种药的比例，初治组为９２％，显著低于复治组的５００％（Ｐ＜００１）。结论老年人肺结核耐药情况严重，尤其是获得性耐药和耐多药比例偏高，应引起足够重视 Objective To investigate the drug resistance of sputum TB in elderly patients with pulmonary tuberculosis. Methods The BACTEC method was used to detect the drug resistance of 134 cases of sputum Mycobacterium tuberculosis in elderly sputum bacillary positive pulmonary tuberculosis patients. Results The initial drug resistance rate was 368% in elderly patients with pulmonary tuberculosis, which was significantly lower than 759% (P <001) of acquired drug resistance rate. The resistance rates of INH, RIF , R), streptomycin (SM, S) were also significantly lower than the latter (P <0  01). The rate of resistance to 2 and 3 drugs in the primary treatment group was 66% and 53%, which was significantly different from that in the retreatment group (224% vs 277%, P <001). The proportion of the two drugs resistant to isoniazid and rifampin was at least 92% in the newly diagnosed group, which was significantly lower than that in the retreatment group (500%, P <001). Conclusions Elderly people have a serious case of drug-resistant pulmonary tuberculosis, especially those with high rates of acquired drug resistance and multi-drug resistance, which should be given sufficient attention