依赖利福平菌肺结核43例临床分析

中国防痨杂志 ›› 2003, Vol. 25 ›› Issue (2): 104-106.

依赖利福平菌肺结核43例临床分析

钟明¹；钟敏¹；娄乐山¹；温博海²；王安容¹；曹沙莉¹；孙川龙¹；尹慧国¹；

1重庆市肺科医院重庆 400020；2第三军医大学微生物学教研室重庆 400038；

出版日期:2003-02-10 发布日期:2003-11-03
基金资助:
重庆市医学重点项目资助 (NO.99-1002)

Clinical Analysis of pulmonary tuberculosis in 43 cases cause by-depending strains

ZHONG Ming,ZHONG Min,LOU Le-shan,et al.

Chongqing Pulmonology Hospital, Chongqing 400020

Online:2003-02-10 Published:2003-11-03

摘要/Abstract

摘要： 目的　探讨依赖利福平(R)结核分支杆菌肺结核的临床特征、产生原因及防治对策。方法对实验室诊断为依赖R菌的肺结核患者进行治疗和随访追踪,对其临床资料进行回顾性分析。结果(1)43依赖R菌肺结核患者中,年龄20～39岁的占60.5%(26/43),40～59岁的占20.9%(9/43);病灶范围≥3个肺野的占88.4%(38/43),病变性质以干酪空洞为主的占58.1%(25/43);耐药种类≥3种抗结核药的占88.4%(38/43),≥2种的为100%(43/43),至少耐异烟肼和利福平的耐多药肺结核(MDR-TB)占74.4%(32/43)。(2)5例初始患者均为MDR-TB,且化疗全部失败;38例复治患者化疗失败率达52.6%(20/38),利福霉素类药物交替使用或不规则用药的占76.3%。结论 (1)依赖R菌肺结核以病情重,耐多药,化疗效果差和预后不良为主要临床特征。(2)肺结核患者长期不合理或不规则用利福霉素类药,可能是产生依赖R菌的主要原因。(3)建立结核菌耐药性检测的快速方法,并应用于临床,是及时了解耐药情况的重要手段。

关键词: 分支杆菌,结核, 依赖利福平生长, 结核,肺

Abstract: Objective To evaluate the clinical feature of pulmonary tuberculosis by rifampin-depending strains,the produce cause and avoid countermove. Methods The pulmonary tuberculosis by rifampin-depending strains were analyzed retrospectively.Results It was 60.5% (26/43) and 20.9%(9/43) in the age of 22～39 and 40～59 years group respectively,the percent rates was 88.4% (38/43) in the cases of focus scope ≥3 field of lungs:88.4%(38/43), caseation and vacuolation:58.1%(25/43),and the multidrug resistance was 88.4(38/43).The chemotherapy of 5 patients,all of primary treatment and multidrug resistance,was entire failure,and the failure rates of chemotherapy was 52.6%(20/38) in the 38 cases with relapsing patients.The abusing rate of rifampin was 76.3% in this group researched.Conclusion (1)It is main clinical feature that the patients possesses severe condition,multidrug resistance and bad prognosis.(2)That is major reason possible to abuse the drugs of rifampins.(3)To establish the method for rapid detection of drug resistance is the key to prevent producing rifampin depending strains.

Key words: Mycobacterium,tuberculosis, rifampin-depending growth, tuberculosis/lungs

钟明,钟敏,娄乐山,温博海,王安容,曹沙莉,孙川龙,尹慧国,. 依赖利福平菌肺结核43例临床分析[J]. 中国防痨杂志, 2003, 25(2): 104-106.

ZHONG Ming,ZHONG Min,LOU Le-shan,et al.. Clinical Analysis of pulmonary tuberculosis in 43 cases cause by-depending strains[J]. Chinese Journal of Antituberculosis, 2003, 25(2): 104-106.