早期广泛耐药肺结核近期临床疗效分析
李哲明;谭守勇;邝浩斌;李艳;覃红娟
【期刊名称】《实用医学杂志》 【年(卷),期】2016(032)011
【摘要】Objective To analyze the clinical efficacy of pre-extensive drug resistant tuberculosis (pre-XDR-TB), and to explore the feasibility of using the standard multidrug resistant tuberculosis (MDR-TB) therapeutic regimen to treat the patients with pre-MDR-TB. Methods A retrospective analysis was made for 126 cases of the MDR-TB patients who were received the treatment in Guangzhou chest hospital from 2009 to 2013. It was divided into MDR-TB group, pre-XDR-TB group and XDR-TB group according to the drug sensitive test (DST) of quinolone(levofloxacin, moxifloxacin) and aminoglycoside (amikacin). All patients were treated for 6-months with the standard therapeutic regimen including Am(Cm), Lfx(Mfx), Pto, PAS and PZA. Results (1) There were 126 cases of the MDR-TB patients in the study, 31 cases (24.6%) complicate
with
aminoglycosides-resistance,
69
cases
(54.7%)
complicate with quinolone-resistance. (2) The negative rate of MDR-TB group, pre-XDR-TB group and XDR-TB group was 82.0%, 55.8% and 29.2% respectively (χ2 = 20.110, P < 0.001). (3)The negative rate of pre-XDR-TB group significantly lower than MDR-TB group (χ2 = 8.146, P = 0.004). The negative rate of pre-XDR-TB group higher than XDR-TB
group (χ2= 4.661, P = 0.031). Conclusions The situation of quinolone and aminoglycoside resistance was high in the patients with MDR-TB. We should carry out the detection of quinolone and aminoglycoside resistance in clinical treatment. The clinical efficacy for the patients with pre-XDR-TB was significantly poorer than the patients with MDR-TB using the standard MDR-TB therapeutic regiment treated.%目的：对早期广泛耐药肺结核病近期临床疗效进行分析，探讨采用标准耐多药结核病方案治疗早期广泛耐药结核病的可行性。方法：回顾性分析2009－2013年在广州市胸科医院治疗的耐多药肺结核126例。根据治疗前喹诺酮类或氨基糖苷类药物的耐药情况分为耐多药结核（MDR-TB）组、早期广泛耐药结核（pre-XDR-TB）组和广泛耐药结核（XDR-TB）组。其中MDR-TB组50例，pre-XDR-TB组52例，XDR-TB组24例。所有患者采用含有阿米卡星（卷曲霉素）、左氧氟沙星（莫西沙星）、丙硫异烟胺、对氨基水杨酸、吡嗪酰胺组成的治疗方案，完成6个月注射期治疗。结果：（1）纳入研究126例中，氨基糖苷类耐药31例（24．6％），喹诺酮类耐药69例（54．8％）。（2）MDR-TB组痰菌阴转率为82．0％，pre-XDR-TB组痰菌阴转率为55．8％， XDR-TB组痰菌阴转率为29．2％（字2＝20．110，P＜0．001）。（3） pre-XDR-TB组痰菌阴转率明显低于MDR-TB组（字2＝8．146，P ＝0．004）；pre-XDR-TB组痰菌阴转率较XDR-TB组高（字2＝4．661，P ＝0．031）。结论：在耐多药结核病中，喹诺酮类药和氨基糖苷类耐药率高，临床治疗时应开展喹诺酮类和氨基糖苷类耐药检测。采用标准耐多药方案治疗，pre-XDR-TB治疗效果较MDR-TB疗效差。
【总页数】3页(1764-1766) 【关键词】结核,肺;耐多药;治疗
【作者】李哲明;谭守勇;邝浩斌;李艳;覃红娟
【作者单位】510182 广州医科大学;510095 呼吸疾病国家重点实验室、广州市胸科医院结核科;510095 呼吸疾病国家重点实验室、广州市胸科医院结核科;510095 呼吸疾病国家重点实验室、广州市胸科医院结核科;510095 呼吸疾病国家重点实验室、广州市胸科医院结核科 【正文语种】中文 【中图分类】 【文献来源】
https://www.zhangqiaokeyan.com/academic-journal-cn_journal-practical-medicine_thesis/0201250232378.html 【相关文献】
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早期广泛耐药肺结核近期临床疗效分析
