【摘要】 目的 提高对耐多药肺结核(multidrug-resistant tuberculosis, MDR-TB)患者治疗转归的认识。方法 回顾性分析徐州市2009年—2012年纳入“全球基金结核病控制项目”治疗的128例MDR-TB患者的转归情况。结果 128例MDR-TB患者中，治愈78例，治愈率为60.94%,不良反应失败10例，其他失败22例，死亡13例，丢失3例，其他(迁出患者，治疗结果未知)2例；统计分析不同肺部病变MDR-TB患者的治愈率，病变累及部分肺野患者的治愈率明显高于累及全肺野患者(χ~2=6.767,P<0.05); 6个月末痰检阴性患者的治愈率高于阳性患者(χ~2=6.677,P<0.05);采用标准化方案与个体化方案的患者治愈率分别为47.69%、74.60%,两者差异有统计学意义(χ~2=4.309,P<0.05)。结论 MDR-TB患者在“全球基金结核病控制项目”的管理、治疗下，获得效果较好。病变累及部分肺野、6个月末痰检阴性、采用个体化治疗方案的MDR-TB患者疗效更好。更多还原

【Abstract】 Objective To improve the understanding of outcomes of multidrug resistant tuberculosis(MDR-TB). Methods The outcomes were collected from 128 MDR-TB patients who were treated and managed according to "the Implementing Rules for Global Fund TB Project" from 1 January 2009 to 31 December 2012 in Xuzhou before retrospective analysis. Results Among all MDR-TB participants were 78 cured patients(60.94%), while 10 cases of failure were reported due to adverse reactions, and 22 cases of failure due to other reasons, in addition to 13 cases of death, 3 discontinued cases and 2 other cases(transfer and unknown outcome). Compared with MDR-TB patients with full injured lungs, a higher cure rate was measured among those whose lungs were partially injured(χ~2=6.767, P<0.05). Meanwhile, negative sputum culture participants produced a cure rate at the end of month 6 which was higher than positive patients(χ~2=6.677, P<0.05). The cure rate was 47.69% for patients receiving the standardized treatment regimen, which was statistically different from that of those given individualized regimens(74.60%)(χ~2=4.309, P<0.05). Conclusion The outcomes of MDR-TB patients included into the Project are satisfactory. Participants who report better efficacy are those with partial lung lesions, negative sputum at the end of month 6, and treated with individualized regimens.更多还原