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目的:分析复治涂阳肺结核老年患者的临床特征及耐药性特点，为临床治疗提供参考。方法:回顾性分析2017年7月至2019年7月同济大学附属上海市肺科医院结核科收治的复治涂阳肺结核患者100例，以60岁年龄为界限分为老年组(77例)和非老年组(23例)，分析并比较两组患者的临床特征，并按照相关规程操作检测12种抗结核药物的敏感性数据，计算耐药率以及比较不同药物的耐药情况。结果:本研究中的100例复治涂阳肺结核患者，男性74例(74.0%)、女性26例(26.0%)；并发症以气管支气管结核为主(18.0%)、并发症主要为糖尿病(12.0%)；且80.0%以上者接受过1～2次治疗方案。在12种抗结核病药物敏感性测试中，耐药率居于前3位的分别为异烟肼(52.0%、52/100)、利福平(39.0%、39/100)和乙胺丁醇(23.0%、23/100)，且老年组对于异烟肼(62.3%、48/77)和利福平(46.8%、36/77)的耐药率显著高于非老年组17.4%(4/23)、13.0%(3/23)(n χ2＝14.334、8.459，n P＝0.000、0.004)；在耐多药菌谱中，以异烟肼和利福平的组合比例最高，其中也包括含有乙胺丁醇或氧氟沙星的药物组合。比较老年组和非老年组的耐药率结果显示，老年人群的耐药率(67.5%、52/77)显著高于非老年人群(34.8%、8/23)(n χ2＝10.203，n P＝0.001)，且涵盖耐药谱广泛。n 结论:耐多药菌谱的形式具有多样性，了解本地区老年患者群体耐药监测数据有助于以此为基础设计更优化合理的治疗方案，为老年人肺结核的规范化诊治指南的制定及干预措施、防控策略的制定提供依据。“,”Objective:To analyze clinical characteristics and drug resistance in the re-treatment of elderly versus non-elderly patients with smear-positive pulmonary tuberculosis, in order to provide the reference for clinical treatment.Methods:A total of 100 inpatients with recurrent smear-positive pulmonary tuberculosis in our hospital from July 2017 to July 2019 were divided into the elderly group(≥60 years old, n=77)and the non-elderly group(<60 years old, n=23)in the retrospective analysis.Clinical features were analyzed and compared between the two groups.Sensitivity of 12 anti-tuberculosis drugs was detected according to the relevant procedures.The drug resistance rate was calculated and compared between 12 anti-tuberculosis drugs.Results:Of the 100 patients, 74 were male(74.0%)and 26 were female(26.0%), aged 31-81(55.2±17.5)years.Complications were mainly tracheobronchial tuberculosis(18.0%)and the co-existing disease was mainly diabetes(12.0%). And more than 80.0% of the patients received 1-2 times of anti-tuberculosis therapy.Of 12 anti-tuberculosis drug sensitivity tests, the top-three drug resistance rates were isoniazid(52.0%, 52/100), rifampicin(39.0%, 39/100)and ethambutol(23.0%, 23/100), respectively.The drug resistance rates to isoniazid and rifampicin were higher in the elderly group than in the non-elderly group(62.3% or 48/77 n vs.17.4% or 4/23, 46.8% or 36/77 n vs.13.0% or 3/23, n χ2=14.334 and 8.459, n P=0.000 and 0.004). Among the multidrug resistant bacteria spectra, the ratio of isoniazid and rifampicin combination was the highest, including combinations containing ethambutanol or ofloxacin.As comparing the drug resistance rate between the elderly group and the non-elderly group, the results showed that the drug resistance rate was higher in the elderly group(67.5%, 52/77)than in the non-elderly group(34.8%, 8/23)(n χ2=10.203, n P=0.001), which covered a wide range of drug resistance spectra.n Conclusions:The forms of multidrug-resistant tuberculosis strains are diverse.A detailed understanding of drug resistance monitoring data of a population of elderly patients is helpful to design more optimized and reasonable treatment plans, which can provide a superior basis for the formulation of standardized diagnosis and treatment guidelines, intervention measures and prevention and control strategies for pulmonary tuberculosis in the elderly.