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中国防痨杂志 ›› 2006, Vol. 28 ›› Issue (3): 148-151.

• 论著 • 上一篇    下一篇

河南省安阳市耐药肺结核病人治疗转归分析

常保珍；朱丽霞   

  1. 河南省安阳市结核病防治所 安阳 455000
  • 出版日期:2006-03-10 发布日期:2006-11-03

Analysis on treatment outcome of drug-resistant pulmonary tuberculosis patients in Anyang of Henan province

Chang Baozhen,Zhu Lixia   

  1. The tuberculosis station in Anyang City of Henan Province,Anyang 455000,China
  • Online:2006-03-10 Published:2006-11-03

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摘要： 目的为了解安阳市耐药肺结核病人治疗转归现况,为今后耐药病人的管理与治疗提供参考依据。方法将安阳市结核病防治所1994年6月至2004年6月10年间登记的耐药肺结核病人病历资料收集统计,进行回顾性总结分析。结果10年登记耐药肺结核病人221例,其中,初始耐药115例,获得性耐药106例;耐1药87例,耐2药57例,耐3药以上77例;MDR-PTB 60例;全程管理177例,自服药44例;标化治疗122例,个体化治疗99例;规则服药完成疗程165例,丢失56例。221例耐药肺结核病人1年转归总治愈率52.5%,丢失率25.3%。初始耐药病人治愈率67.0%,其中标化治疗耐1药病人治愈率88.1%;获得性耐药病人治愈率36.8%,其中标化治疗耐1药病人治愈率37.5%;MDR-PTB病人治愈率30.0%;规则服药完成疗程病人治愈率70.3%。结论短程标准化疗方案治疗初始耐药病人,特别是耐1药病人有较高的疗效,治疗获得性耐药病人及MDR病人效果较差。丢失率偏高是影响疗效的重要因素。建议对耐药病人实行专项登记,专项考核,强化管理措施,努力降低丢失率,减少难治性肺结核的发生。

关键词: 结核,肺/预防和控制, 抗药性, 治疗, 安阳市

Abstract: Objective To determine the treatment outcome of drug-resistant pulmonary tuberculosis patients in Anyang of Henan province,so as to provide reference evidences for policy making for management of drug-resistant pulmonary patients in the future. Methods Retrospective analysis the information of drug-resistant pulmonary patients registered in Anyang Tuberculosis Dispensary from June 1994 to June 2004. Results Two hundred and twenty-one drug-resistant pulmonary tuberculosis patients registered in ten years.One hundred and fifteen cases were initial drug-resistance.One hundred and six cases were acquired drug-resistance;87 cases were resist to one drug,57 cases were resist to two drugs,77 cases were resist to three and more drugs.Sixty cases were multi-drug resistance cases.The treatment management of the cases are as followings: 177 cases with full-course management;44 cases with self-management.One hundred and twenty-two cases were prescribed with standardized regimens and 99 cases were prescribed with individual regimen.165 cases completed the treatment with regular drugs taking. 56 cases were default.The cure rate of 221 drug-resistance cases was 52.5%.The default rate was 25.3%.The cure rate of inital drug-resistant caseswas 67.0%.The cure rate of 1 drug resistance cases with standardized treatment regimen was 88.1%.The cure rate of acquired drug-resistance cases was 36.8%.Thecure rate of 1 drug resistance cases with standardized treatment regimen was 37.5%.The cure rate of multi-drug resistance cases was 30%.The cure rate of the patients who took medicine regularly was 70.3%. Conclusion The standardized treatment regimen have a higher effect to the initial drug-resistant patients,a lower effects to the acquired drug-resistant patients and MDR patients.The higher default rate is important impact factor for treatment outcome.We should be careful of selecting the individual regiment for the drug-resistance patients.We suggest that drug-resistance pulmonary tuberculosis patients should be registered separately and strengthen management to prevent treatment default so as to reduce the occurrence of hard to be treated cases.

Key words: Pulmonevry tuberculosis/prevention and control, drug-resistant, Treatment, Anyang city

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