肺结核患者耐药性动态监测分析和评价.docVIP

肺结核患者耐药性动态监测分析和评价 　　[摘要] 目的：探讨住院肺结核患者动态耐药现状，评价并指导临床用药。方法：采用120全自动分枝杆菌检测仪对766例痰结核菌涂阳患者进行4种常用抗结核药物的动态耐药性检测。结果：结核分枝杆菌的总耐药率为37.21%，初治耐药率为35.06%，初治多药耐药率为5.03%；复治耐药率为46.0%，复治多药耐药率为14.0%。与初治耐药率比较，复治耐药率对4种药物有不同程度升高。户籍人口与暂住人口对抗结核药的耐药性无明显差异。结论：肺结核患者初治和复治耐药率及总耐药率仍处在较高水平，应进一步加强结核病的动态监控。 　　[关键词] 肺结核；单药耐药；多药耐药；药物评价；全自动分枝杆菌检测仪 　　[中图分类号]R195.4 [文献标识码]A [文章编号]1673-7210（2008）09（c）-112-02 　　 　　Analysis and evaluation of dynamic monitoring of drug resistance in patients with pulmonary tuberculosis 　　LIANG Shao-qiong, LI Guo-hui, LIAO Chao-feng 　　(Baoan Peoples Hospital of Shenzhen, Shenzhen 518101, China) 　　[Abstract] Objective: To study the present status of dynamic drug resistance in hospitalized patients with pumonary tuberculosis, then to guide the clinical medication. Methods: Dynamic drug resistance inspection of four kinds of commonly used anti-tuberculosisdrugwas used to 766 patients with positive smear of bacillus tuberculosis in sputum by 120 automatic mycobacteria inspection device. Results: The total drug tolerance rate of bacillus tuberculosis was 37.21%, while initial drug tolerance rate was 35.06%, initial multi-drug tolerance rate was 5.03%, acquired drug tolerance rate was 46.0%, and acquired multi-drug tolerance rate was 14.0%. The acquired drug tolerance rate to the four kinds of drug increased in different quantities compared to the initial drug tolerance rate. The drug tolerance rate had no obvious difference between the permanent citizens and temporary population of Baoan district of Shenzhen. Conclusion: The initial, acquired and total drug tolerance rate of pumonary TB patients are still at high level, so dynamic monitoring to TB should be enhanced. 　　[Key words] Pulmonary tuberculosis; Single drug tolerance (resistance); Multi-drug tolerance (resistance); Drug evaluation; Automatic mycobacteria inspection device 　　 　　结核分枝杆菌高耐药和耐多药问题是结核病病情恶化的重要原因，已成为当前结核病临床和防治工作的难题。深圳市流动人口比常住人口多，为了掌握深圳市结核病耐药性流行现状及特点，笔者对住院肺结核患者的耐药状况进行动态监测，并指导临床用药，获得满意结果，现报道如下： 　　1 对象