【摘要】 目的了解初治和复治肺结核患者对抗结核化学药物的敏感性。方法收集2006年6-12月痰菌阳性标本,用改良酸性罗氏培养基培养,按绝对浓度法对结核菌株经PNB、TCH鉴别分型后的结核分枝杆菌作为药物敏感试验对象;对全部培养阳性标本进行4种抗结核药物(异烟肼、利福平、乙胺丁醇、链霉素)的耐药性检测。结果共检出217株结核分枝杆菌,总耐药率为65.90%,初始耐药率39.81%,其中耐多药(所耐药物中含异烟肼和利福平)18例,初始耐多药率16.67%;获得性耐药率91.74%,获得性耐多药率74.31%;初治期间不规则用药和不满规定疗程自行停药共占71.6%,是耐药产生的主要原因。结论耐药的主要原因为不规则治疗所致,抓好初治病例合理化疗和贯彻全程治疗原则是防止耐药和耐多药的关键。更多还原

【Abstract】 OBJECTIVE To understand the susceptibility to antituberculous agents for patients with primary and acquired drug resistance of Mycobacterium tuberculosis. METHODS M. tuberculosis positive sputum samples were collected from Jun to Dec 2006. Ameliorative Lowenstein-Jensen culture medium was used to detect bacillus-positive specimen of pulmonary tuberculosis by typing using PNB and TCH. Totally 217 samples were confirmedtobe positive by culturing. Drug susceptibility test against streptomycin (SM),isoniazid (INH),rifampicin (RFP) and ethambutol (EMB) was conducted. RESULTS The total drug resistance rate was 65.90%,the initial drug resistance rate was 39.81% and the initial multi-drug resistance rate was 16.67% ;the acquired drug resistance rate was 91.74%,and the acquired multi-drug resistance rate was 74.31%. The main causes of drug resistance were irregularit of treatment at beginning and preterm stop of the freatment course by patients own selves,which accounted for 71.6%. CONCLUSIONS The drug resistance of M. tuberculosis is caused by irregular treatment,so the key to prevent and control drug resistance is rational and whole-course treatment.更多还原