中国防痨杂志2018，Vol.40Issue(3)：286-291,6.DOI:10.3969/j.issn.1000-6621.2018.03.014
不同方案治疗单耐异烟肼或利福平肺结核患者的预后分析
Prognosis of different regimens in pulmonary tuberculosis patients with mono-resistance to isoniazid and rifampicin
摘要
Abstract
Objective To analyze the prevalence of multidrug-resistant tuberculosis (MDR-TB) after treat ment with different regimens in patients with mono-resistance to isoniazid (H) and rifampicin (R),in order to guide rational drug use in clinical settings.Methods From January 2010 to December 2014,332 pulmonary tuberculosis patients with mono-resistance to H and 114 pulmonary patients with mono-resistance to R identified by the drug resistance surveillance project in Puyang City,He'nan Province were enrolled as the study subjects.The subjects were randomized (through simple randomization among patients with mono-resistance to H and R respectively) into standard chemotherapy group (a total of 222 cases on regimens according to the standardized chemotherapy for naive and retreated patients,referred to as "standard group");and the levofloxacin chemotherapy group (a total of 224 cases on regimens based on the drug sensitivity test results,containing levofloxacin chemotherapy,referred to as "levofloxacin group").The incidence of MDR-TB after treatment in both groups was observed.SPSS 20.0 statistical software package was used for statistical analysis,and the group comparison was performed using x2 test.P＜0.05 was considered statistically significant.Results The incidence of MDR TB was 11.7％ (26/222) in the standard group,and 4.9％ (11/224) in the levofloxacin group and the difference was statistically significant (x2 =6.779,P=0.009).Among the newly diagnosed patients,the incidence of MDR-TB was 4.4％ (8/180) in the standard group and 2.2％ (4/185) in the levofloxacin group,with no significant difference between the two (x2 =1.495,P=0.222).Among the retreated patients,the incidence of MDR-TB was 42.9％ (18/42) in the standard group and 17.9％ (7/39) in the levofloxacin group,with statistical difference (x2 =5.880,P=0.015).Among the patients with mono-resistance to R,the incidence of MDRTB was 37.5％ (21/56) in the standard group and 17.2％ (10/58) in the levofloxacin group,with the difference being statistical significance (x2 =5.906,P=0.015).Among the retreated patients with mono-resistance to R,the incidence of MDR-TB was 56.5％ (13/23) in the standard group,and 27.3％ (6/22) in the levofloxacin group,and the difference was statistically significant (x2=3.493,P=0.047).Conclusion Among naive patients with mono-resistance to H and R,standard chemotherapy does not increase the risk of developing MDR-TB.Pulmonary tuberculosis patients with mono-resistance to R are more prone to develop MDR TB,compared with those with mono-resistance to H,especially those retreated patients with mono-resistance to R.关键词
结核,肺/抗药性/药物疗法,联合/临床方案/治疗结果/数据说明,统计Key words
Tuberculosis, pulmonary/Drug resistance/Drug therapy, combination/Clinical regimens/Treatment outcome/Data interpretation, statistics引用本文复制引用
王茂军,马丙乾,郝俊玲,付志华,董淑敏,曹艳竹..不同方案治疗单耐异烟肼或利福平肺结核患者的预后分析[J].中国防痨杂志,2018,40(3):286-291,6.基金项目
河南省濮阳市科技计划项目(140625) （140625）
