目的探讨扬州市初治失败肺结核的耐药情况,寻求治疗初治失败肺结核的合理有效的方法。方法 60例初治失败肺结核患者随机分为两组,治疗组采用3AHPZVTh/9PaVTh方案治疗,对照组采用标准复治涂阳2H3R3Z3E3/4H3R3方案治疗,并对所有60例患者作结核菌药物敏感试验。结果扬州市初治失败肺结核耐药率81.7%,耐多药率23.3%,两组方案满疗程后痰菌阴转率分别为86.2%、63.3%,有显著性差异(P<0.05)。胸部影像学病灶吸收好转率分别为93.1%、80.0%,治疗组也优于对照组。结论 3AHPZVTh/9PaVTh方案治疗初治失败肺结核,疗效肯定,有推广价值。 Objective To investigate the drug resistance of failed initial pulmonary tuberculosis in Yangzhou city and seek a reasonable and effective method for treating initial failed pulmonary tuberculosis. Methods Sixty patients with initially untreated pulmonary tuberculosis were randomly divided into two groups. The treatment group was treated with 3AHPZVTh / 9PaVTh regimen. The control group was treated with standard treatment regimen of 2H3R3Z3E3 / 4H3R3. All the 60 patients were tested for drug susceptibility to TB. Results The initial failure rate of pulmonary tuberculosis in Yangzhou was 81.7% and the rate of multidrug resistance was 23.3%. The sputum negative conversion rates in the two groups after treatment were 86.2% and 63.3%, respectively (P <0.05). Chest imaging lesions absorption rate were 93.1%, 80.0%, the treatment group is also superior to the control group. Conclusion 3AHPZVTh / 9PaVTh regimen for the treatment of failed initial pulmonary tuberculosis, positive effect, with the promotion of value.