资源描述：
《152例耐多药肺结核的临床观察》由会员上传分享，免费在线阅读，更多相关内容在工程资料-天天文库。
1、152例耐多药肺结核的临床观察【摘要】目的探讨耐多药结核（MDR-TB）的临床特点。方法回顾性分析2002年1月一2006年1刀丁•我院住院的I耐多药肺结核的患者152例，随访观察2年。结果耐多药结核的高发年龄段为18〜59岁，占82.89%o不规律用药患者中，女性较男性比例高（Pv0.05）,平均抗结核治疗年数为3.97±3.44年，抗结核治疗次数为3.02±1.35次。除一•线抗结核药物外，L、Re、AK、Pa、Pt的使用情况较多。82%的患者耐4药及以上，耐药的次序依次为H>R>S>E,在二线药物中，L的耐药发生率最高，为29.60%。2年疗程结束后，耐多药患者病灶的吸收率
2、仅为19.73%；痰菌阴转率为28.29%；治愈率为28.29%,稳定36.18%,恶化及死亡率总计35.53%。结论耐多药结核治疗效果差。对疗程4年左右，治疗3次左右的青中年患者，尤其是肺部多发空洞的持续痰结核菌阳性患者，医师耍高度警惕耐多药结核的町能。【关键词】耐多药结核临床研究Clinicalobservationof152patientswithmulti-drugresistanttuberculosisGUJin,XIAOHe-ping,TANGShen-jie.PulmonaryHospitalofShanghaiCityAffiliatedtoTongjiUniv
3、ersity,Shanghai200433,China[Abstract]ObjectiveTodiscusstheclinicalfeaturesofmulti-dmgresistanttuberculosis（MDR-TB）.Methods152inpatientsofMDR-TBinourhospitalfromJanuary2002toJanuary2006wereanalyzedretrospectivelyandfollowed-uptwoyears.ResultsThehighincidenceofMDR-TBwasinageof18to59,accountedfo
4、r82.89%ofthetotal,and63.82%ofMDR-TBpatientsfromotherprovinces.Inpatientswithirregulardruguse,theproportionofwomenwashigherthanthatofmale（P<0.05）.TheaveragetreatmentyearsofMTR-TBwere3.97±3.44years,thetimesoftreatmentinMTR-TBwere3.02±1.35.Besidethefirst-lineanti-tuberculosisdrugs,L、Re>AK、Pa、Pth
5、adthehigherusagerate.82%ofMTR-TBpatientshadresisted4drugsorabove,theresistanceorderwasH>R>S>E.Intheseconlinedrugs,Lhadthehighestincidenceofdrugresistance,accountedfor29.60%ofthetotal.After2yearsoftreatment,thelesionsabsorptionratewas19.73%inMTR-TBpatients,sputumconversionratewas28.29%,curerat
6、ewas28.29%,stablewas36.18%,anddeteriorateordeathratewas35.53%.ConclusionThetreatmenteffectofMTR-TBisunsatisfactory.PhysiciansshouldbevigilantoftheincidenceofMTR-TBforthemiddle-agepatientswhichhadreceivedthetreatmentforabout4years,3times,especiallywhichhadmultipletuberculouscavitiesandpositive
7、tuberclebacillusinsputum.[Keywords]MDR-TB;clinicalresearch近年來，全球结核病疫情的冋升已经引起了人们的高度重视，第四次结核病流行病学调杏显示在我国结核病耐药率高达27.8%,初始耐药率18.6%,获得性耐药率46.5%,高耐药率和耐多药菌株的不断扩散，导致治愈率卜降和治疗失败病例的增加，岀现更多难以治愈的慢性传染源。木文冋顾性分析了152例耐多药结核患者的临床资料，便临床医师能了解耐多药结核（MDR-TB）临床特点，提高对
