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目的分析探讨耐多药结核病(MDR-TB)患者的耐药情况和形成耐药原因。方法对2010年1月至2011年12月泰安市结核病防治院就诊的51例MDR-TB患者,分析耐药情况和耐药形成原因。结果 51例MDR-TB患者中,男性为70.59%(36/51),64.71%(33/51)的患者为农民,住院两次及以上的占29.41%(15/51),有过结核病密切接触史的患者为17.65%(9/51),胸片显示有空洞的患者为41.78%(21/51),合并肺部其他疾病、糖尿病的患者分别占50.98%(26/51)和19.61%(10/51)。MDR-TB耐药率为13.11%(51/389),17.65%的新患者曾用抗结核药。初治痰培养阳性肺结核患者中耐多药率为8.30%(24/289),复治痰培养阳性肺结核患者中耐多药率为27.00%(27/100),差异有统计学意义(P<0.05)。MDR-TB患者的耐药谱中,对INH+RFP、RFP+INH+SM、RFP+INH+SM+EMB、RFP+INH+EMB+PAS这4种组合常见。结论 51例MDR-TB患者以中年男性为主,耐药谱比较复杂,复治患者和曾用过抗结核药的初治患者易导致MDT-TB的发生,应加强肺结核患者的宣教管理,规范化治疗。
Objective To investigate the drug resistance and drug resistance in patients with multidrug-resistant tuberculosis (MDR-TB). Methods 51 patients with MDR-TB from January 2010 to December 2011 in Taian TB Prevention and Treatment Hospital were analyzed for drug resistance and drug resistance. Results Among the 51 patients with MDR-TB, 70.59% (36/51) were male, 64.71% (33/51) were farmers, 29.41% (15/51) were hospitalized twice or more and had close tuberculosis The history of exposure was 17.65% (9/51), the chest radiograph showed 41.78% (21/51) of patients with pneumonia, and 50.98% (26/51) and 19.61% of patients with diabetes and other pulmonary diseases, respectively (10/51). MDR-TB drug-resistant rate was 13.11% (51/389), 17.65% of new patients had used anti-TB drugs. The MDR rates of sputum culture positive TB patients were 8.30% (24/289) in initial sputum culture and 27.00% (27/100) in sputum culture positive pulmonary tuberculosis patients, the difference was statistically significant (P < 0.05). MDR-TB patients resistance spectrum, INH RFP, RFP INH SM, RFP INH SM, EMB RFP INH EMB-PAS these four combinations are common. Conclusion 51 cases of MDR-TB patients are predominantly middle-aged men and their drug resistance spectrum is complex. Patients with re-treatment and those who have used anti-TB drugs can easily lead to the development of MDT-TB. The management of TB management should be strengthened, Standardized treatment.