耐多药肺结核发现及治疗现状分析

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目的研究耐药结核病发现及治疗效果,为防控耐药结核病流行提供科学依据。方法对284例耐药肺结核耐药性状、抗结核治疗情况、治疗转归和不良反应状况进行分析。结果 284例患者中耐多药患者256例,广泛耐多药患者28例。男199例,女85例;男性多于女性。18~60年龄组238例,占83.80%。初始耐药和获得性耐药患者对四种受试药物的耐药频率获得性耐药远远高于初始耐药,有显著差异(X~2=288.137,P<0.05;X~2=202.193,P<0.05;X~2=28.738,P<0.05;X~2=92.806,P<0.05)。等待治疗和治疗过程中死亡49例,病死率达17.25%,治愈率仅仅21.92%,治疗成功率58.90%,不良反应发生率高达60.85%。结论耐药结核病疫情严重,危害巨大,死亡率高,治愈率低,防控形势非常严峻。需要制定相关政策并提供财力支持,控制耐药结核病的发生。 Objective To study the discovery and treatment of drug-resistant tuberculosis and provide a scientific basis for preventing and controlling the epidemic of drug-resistant tuberculosis. Methods The drug resistance traits, anti-TB treatment, treatment outcome and adverse reactions in 284 drug-resistant pulmonary tuberculosis patients were analyzed. Results Of the 284 patients, 256 patients were resistant to multidrug-resistant drugs and 28 patients were resistant to multidrug-resistant drugs. 199 males and 85 females; more males than females. 238 cases of 18 ~ 60 age group, accounting for 83.80%. The initial drug resistance and acquired drug resistance in patients with four kinds of test drug resistance frequency acquired resistance is much higher than the initial resistance, there were significant differences (X ~ 2 = 288.137, P <0.05; X ~ 2 = 202.193 , P <0.05; X ~ 2 = 28.738, P <0.05; X ~ 2 = 92.806, P <0.05). 49 cases died during treatment and treatment, the mortality rate reached 17.25%, the cure rate was only 21.92%, the success rate of treatment was 58.90% and the incidence of adverse reactions was as high as 60.85%. Conclusion The epidemic situation of drug-resistant tuberculosis is serious, with great harm, high mortality and low cure rate. The situation of prevention and control is very serious. Need to develop relevant policies and provide financial support to control the occurrence of drug-resistant TB.
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