关键词: 结核, 肺/药物疗法, 直接观察疗法, 复发, 治疗结果, 黑龙江省

Abstract: Objective  To evaluate the long-term treatment outcome of TB patients with or without multidrug-resistance after they were successfully treated by first-line TB drugs under DOTS strategy. Methods  This is a retrospective cohort study design. The cohort study followed up the MDR-TB patients who were diagnosed in a drug-resistance survey in Heilongjiang province in 2004 and were later successfully treated under DOTS strategy. Of the 194 cases of MDR-TB patients successfully treated under the DOTS treatment, 111 were followed up including 40 died during the 4 years and 71 still alive. One survival MDR-TB patients were matched with one Non-MDR-TB patients in control group (71 patients in control group, among which 41 were drug sensitive to any TB drugs, 30 drug resistance cases were drug-resistant but non MDR-TB). The patients were observed for TB recurrence 4 years after successful completion of treatment. We analyzed the influence of MDR (71 MDR-TB cases, 41 drug sensitive cases, 30 non-MDR-TB cases), treatment classification (80 initial treatment cases, 62 retreatment cases), treatment regimen (124 cases with NTP regimens, 18 with research regimens) on the recurrence. Results  In the exposed group, MDR TB recurred in 52 (46.85%) of the 111 patients. This recurrence rate was  67.50% in the dead(27/40), and 35.21%（25/71）in survival 71 cases. In 71 controls, the recurrence rate was 23.94% (17/71). The risk of 4 year recurrence in living MDR-TB patients was significantly higher than those drug sensitive to any TB drugs （χ²=4.19，P=0.041；RR=2.06,95% CI＝0.98-4.34).The risk of recurrence in retreatment TB patients （40.32%，25/62）was significantly higher than those of initial treatment cases （21.25%，17/80）（χ²=6.10，P=0.014；RR=1.90, 95%CI：1.13-3.19). NTP regimen and research regimen had no significant impact on the long-term recurrence 29.84%（37/124）versus ［27.78%（5/18）, χ²=0.02，P=0.894］.Conclusion  The study showed that the 4 years recurrence rate of MDR-TB patients was high. The risk of recurrence is high in retreatment than initial treatment cases.

Key words: Tuberculosis,pulmonary/drug therapy, Directly observed therapy, Recurrence, Treatment outcome, Heilongjiang province