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目的探讨老年肺结核患者结核分枝杆菌的耐药特征. 方法 选取2014年1月至2015年12月在上海市公共卫生临床中心结核科住院并有痰培养及药物敏感性试验(简称“药敏试验”)结果的116例老年肺结核患者(老年组),和同期住院的204例非老年肺结核患者(非老年组),分析两组患者的药敏试验情况.结果 老年组总体耐药率为21.6%(25/116),其中初治患者103例(88.8%),耐药率为20.4%(21/103);复治患者13例(11.2%),耐药率为30.8%(4/13);耐多药患者占4.3%(5/116);非老年组总体耐药率为29.4%(60/204),其中初治患者181例(88.7%),耐药率24.9%(45/181);复治患者23例(11.3%),耐药率65.2%(15/23);耐多药患者占8.8%(18/204);老年组复治患者的耐药率明显低于非老年组复治患者的耐药率(x2=3.96,P=0.047).老年组与非老年组患者耐药的药物顺序前4位均为异烟肼(13.8%,16/116;21.1%,43/204)、链霉素(11.2%,13/116;18.6%,38/204)、利福平(5.1%,6/116;12.2%,25/204)、乙胺丁醇(3.4%,4/116;5.4%,11/204),仅非老年组对利福平的耐药率明显高于老年组,差异有统计学意义(x2=4.24,P=0.039).老年组患者中,60~70岁之间患者耐药率(39.5%,17/43)明显高于70岁以上患者(11.0%,8/73),差异有统计学意义(x2=13.07,P<0.001).结论老年肺结核患者总耐药率、复治患者耐药率明显低于非老年组,临床上需要及时对60~70岁的老年患者和30~60岁的非老年组患者进行药敏试验.“,”Objective To investigate the resistance characteristics of Mycobacterium tuberculosis in elderly patients with pulmonary tuberculosis. Methods From January 2014 to December 2015, 116 elderly pulmonary tuberculosis patients which had sputum culture and drug sensitivity test results and had be hospitalized in Tuberculosis Department of Shanghai Public Health Clinic Center was collected.Two hundred and four non-elderly cases in the same period was collected as control.To analysis the drug susceptibility test of the two groups. Results Overall resistance rate of elderly group was 21.6% (25/116).There was 103 (88.8%) cases was initial treatment patients, 21 cases were drug resistance and the initial drug resistance rate was 20.4%.Thirteen (11.2%) cases were retreatment patients, 4 cases were drug resistance and the acquired drug resistance rate was 30.8%.Five(4.3%) cases were multi-drug resistant patients.Overall resistance rate of non-elderly group was 29.4% (60/204).There was 181 (88.7%) initial treatment patients, 45 cases were drug resistance and the initial drug resistance rate was 24.9% (45/181).Twenty three (11.3%) cases were retreatment patients, 15 cases were drug resistance and the acquired drug resistance rate was 65.2%.Eighteen (8.8%) cases were multi-drug resistant patients.The acquired drug resistance rate of elderly group was lower than that of non-elderly group (x2=3.96,P=0.047).The four most commonly resistant drugs in elderly group and non-elderly group were INH (13.8%,16/116;21.1%,43/204), Sm (11.2%,13/116;18.6%,38/204), RFP (5.1%,6/116;12.2%,25/204) and EMB (3.4%,4/116;5.4%,11/204) sequentially.Only the drug resistance rate of RFP was higher of non-elderly group than elderly group (x2=4.24,P=0.039).The resistance rate of 60-70 years old in elderly patients (39.5%,17/43) was higher than over 70 years old (11.0%,8/73)(x2=13.07,P<0.001). Conclusion The resistance rate of elderly patients is lower than that of non-elderly patients, Mycobacterium tuberculosis susceptibility testing is required for pulmonary tuberculosis patients, and our investigate shows that attention should be focused on 60-70 years old patients and 30-60 years old patients.