南方医科大学学报 ›› 2013, Vol. 33 ›› Issue (02): 287-.

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依赖利福平与耐利福平结核杆菌肺结核的临床特点比较

李艳,谭守勇,罗春明,黎燕琼,覃红娟,冯志宇   

  • 出版日期:2013-02-20 发布日期:2013-02-20

Comparison of clinical characteristics between rifampin-dependent and rifampinresistant patients with pulmonary tuberculosis

  • Online:2013-02-20 Published:2013-02-20

摘要: 目的分析比较依赖利福平结核杆菌(依赖R菌)与耐利福平结核杆菌(耐R菌)肺结核发病特点。方法2008 年10 月~
2012年1月在我院住院或门诊的61例依赖R菌肺结核和148例耐R菌肺结核患者,记录人口学资料、年龄分组、抗结核药化疗
史、药敏试验结果。结果(1)依赖R 菌与耐R 菌肺结核均以30~44 岁年龄组为主;(2)依赖R 菌肺结核初治12 例(12/61=
19.7%),复治49 例;耐R菌肺结核初治11 例(11/148=7.4%),复治137 例;(3)依赖R菌与耐R菌肺结核发生耐多药率分别是
80.3%和92.6%。结论依赖R菌肺结核患者以中青年为主,病情重。对初治肺结核治疗失败病人,检测利福平赖药性具有重要
意义。依赖R菌肺结核病人,在治疗上应参照耐多药治疗方案。

Abstract: Objective To compare the clinical characteristics of rifampin-dependent (R-dependent Mycobacterium tuberculosis)
and rifampin-resistant (R-resistant Mycobacterium tuberculosis) patients with pulmonary tuberculosis. Methods The clinical
data including the demographic data, age groups, course of disease, history of chemotherapy with anti-TB drugs, and results
of drug susceptibility test were collected from 61 cases of R-dependent pulmonary tuberculosis and 148 cases of R-resistant
pulmonary tuberculosis treated between October, 2008 and January, 2012. Results Most of the R-dependent and R-resistant
patients were between 30 and 44 years of age. The R-dependent patients included 12 receiving the first treatment patients and
49 with previous treatments, and the R-resistant patients included 11 without and 137 with previous treatments. The
multi-drug resistant rate was 80.3% in R-dependent group, as compared to 92.6% in R-resistant group. Conclusion Most of the
patients infected with R-dependent Mycobacterium tuberculosis are young or middle-aged, often having serious disease
conditions. Detecting rifampin dependence is important for patients with initial treatment failure. Multi-drug resistance
therapy guideline should be applied to patients infected with R-dependent Mycobacterium tuberculosis to improve the cure rate.