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目的 探讨结核分枝杆菌L型 (MTB -L)在耐多药肺结核 (MDR -PTB)形成及治疗过程中的变化特点 ,为临床诊治提供依据和方法。方法 对 4 0例耐多药肺结核、30例无耐药初治肺结核患者 ,治疗前分别做痰和支气管肺泡灌洗液的结核分枝杆菌培养和结核分枝杆菌L型检测。结果 耐多药肺结核结核分枝杆菌L型阳性率 (支气管肺泡灌洗液 5 2 5 % ,痰 5 0 % )明显高于无耐药初治肺结核 (支气管肺泡灌洗液 1 6 7% ,痰 1 3 3% )。随着耐药种类的增多 ,结核分枝杆菌L型阳性率增高。结论 耐多药肺结核患者有较高的结核分枝杆菌L型感染率 ;复发、耐药、病情进展恶化与结核分枝杆菌L型感染有关
Objective To investigate the characteristics of MTB - L (MTB - L) in the development and treatment of multidrug - resistant pulmonary tuberculosis (MDR - PTB) and provide the basis and method for clinical diagnosis and treatment. Methods 40 cases of multidrug-resistant pulmonary tuberculosis and 30 cases of newly diagnosed non-drug resistant pulmonary tuberculosis patients were treated with sputum and bronchoalveolar lavage fluid before treatment of M. tuberculosis culture and Mycobacterium tuberculosis L-type detection. Results The positive rate of M. tuberculosis M. tuberculosis L positive (bronchoalveolar lavage fluid 52.5%, sputum 50%) was significantly higher than that of non-drug-resistant newly diagnosed pulmonary tuberculosis (bronchoalveolar lavage fluid 16.7%, sputum 1 3 3%). With the increase of resistant species, the positive rate of L type of Mycobacterium tuberculosis increased. Conclusions Patients with MDR-TB have a higher L-type infection rate of Mycobacterium tuberculosis; relapse, drug resistance and progression of the disease are associated with L-type infection of M. tuberculosis