关键词: 结核, 肺, 肺疾病, 结核, 抗多种药物性

Abstract: Objective  To analyze the drug-resistance status and clinical characteristics in 115 tuberculosis cases with collapsed lung and provide the evidence for diagnosis and treatment for drug-resistant tuberculosis.  Methods  115 tuberculosis cases hospitalized with collapsed lung were enrolled from May 2005 to May 2011 and we analyzed the relationship between drug-resistance with types of drug-resistance, distribution, lesions status, duration, and relationship between drug-resistance with treatment of drug-resistant tuberculosis and lung lesions. And according to the duration of three types of longer than 5 years, shorter than or equal to 5 years, shorter than of equal to 1 year, 60 cases with drug-resistance tuberculosis collapsed lung were analyzed the relationship between duration and drug-resistance.  Results  Among 115 cases with collapsed lung, 60(52.2%) cases were drug-resistant, 55 were not. Of the 60 cases with drug-resistant collapsed lung, 3（5.0%） cases had single drug resistance, 15(25.0%) cases had polydrug resistance, 29(48.3%) had multidrug resistance(MDR), 13(21.7%) cases had extensively drug resistance(XDR). Compared with the status of single drug-resistance, polydrug resistance, MDR and XDR，the cases with MDR were prone to develop collapsed lung (χ²=22.933, P<0.001）. Of the 60 cases with drug-resistance, the rates of resistance to anti-tuberculosis drugs were Rifapentine (90.0%, 54/60）, Rifampin(86.7%, 52/60）, isoniazid(71.67%, 43/60），streptomycin(68.3%, 41/60）, Levofloxacin(53.3%, 32/60）, Protionamide (40.0%, 24/60），Ofloxacin (13.3%, 8/60）, capreomycin (10.0%, 6/60）, in which Rifapentine were highest and Ofloxacin and capreomycin were lower. Of the 60 cases with drug-resistance, cases with duration shorter or equal to 1 year were prone to develop drug-resistance, compared with the other two types of duration（χ²=38.800，P<0.001）.Of the cases who showed drug-resistance collapsed lung, the rate of drug-resistance was higher in those whose treatment was irregular than those who received regular treatment, with 43cases（71.7%）and 17 cases （28.3%）,respectively（χ²=11.267，P<0.05）. The cases with multidrug resistance without regular treatment were prone to develop collapsed lung.  Conclusion  The situation of drug-resistance to tuberculosis collapsed lung is very serious, especially for multidrug resistance. It would be better to master the first-year which is the key time for treatment drug resistant tuberculosis to decrease the development of collapsed lung. The high rate of drug resistance of collapsed lung and itself is a reciprocal causation.

Key words: Tuberculosis, pulmonary, Lung diseases, Tuberculosis, multidrug-resistant