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我院耐多药结核病治疗管理及药品不良反应发生情况分析
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| 篇名： | 我院耐多药结核病治疗管理及药品不良反应发生情况分析 |
| TITLE： | |
| 摘要： | 目的：为耐多药结核病（MDR-TB）患者合理使用抗结核药及减少药品不良反应（ADR）提供参考。方法：选取2012年2月－2015 年5月我院结核病住院患者，按照疑似MDR-TB（202例）和确诊MDR-TB（162例）分为两组，进行药物组化疗法，并依据患者病情选择不同的治疗管理方式，并观察ADR发生情况。两组患者的治疗管理期均为18个月。结果：疑似MDR-TB组患者对一线药物的耐药率均≥26.24％，其中对异烟肼和利福平的耐药率为40％左右；对二线药物的耐药率均≥4.95％，其中对丙硫异烟胺耐药率最高，为46.04％；药敏试验结果显示，一线药物全敏感为44.06％，单耐药为14.36％，多耐药为9.90％，耐多药为31.68％；一、二线药物全敏感为21.78％，单耐药为24.75％，多耐药为17.82％，耐多药为32.67％，广泛耐药为2.97％。MDR-TB患者治疗管理方案中，结防机构治疗占56.17％；转诊于专科医院治疗占14.81％；未治疗者占22.22％；其他因素导致改变治疗方案或无法继续治疗占6.79％。确诊MDR-TB患者较疑似MDR-TB患者二线方案诊疗的ADR发生率较高，组间比较差异有统计学意义（P＜0.05）。经后期对症治疗均有所好转。结论：对于MDR-TB患者根据病情可有效寻找合适的治疗管理方案，提高疗效，降低ADR发生率，控制结核杆菌的传播与发展。 |
| ABSTRACT： | OBJECTIVE： To provide reference for rational use of antituberculosis drugs and reduce the occurrence of ADR in multiple-drug resistance tuberculosis （MDR-TB） patients. METHODS： TB inpatients were selected from our hospital during Feb. 2012-May 2015， and then divided into suspected MDR-TB group （202 cases） and diagnosed MDR-TB group （162 cases）. According to the patient’s condition， different treatment management modes were chosen， and the incidence of ADR were observed. Treatment and management period of 2 groups were 18 months. RESULTS： In suspected MDR-TB group， the drug resistance rates to first line drugs were greater than or equal to 26.24％， among which drug resistance rates to isoniazid and rifampicin were about 40％. Resistance rates to second line-drugs were greater than or equal to 4.95％， among which resistance rate to protionamide was the highest， being 46.04％. The results of drug sensitivity tests showed that 44.06％ of patients were sensitive to all first-line drugs， 14.36％ of patients were resistant to single drug， 9.90％ of patients were usually resistant to drugs and 31.68％ of patients were resistant to multiple drugs. 21.78％ of patients were sensitive to all first-line drugs and second-line drugs， 24.75％ of patients were resistant to single drug， 17.82％ of patients were usually resistant to drugs， 32.67％ of patients were resistant to multiple drugs and 2.97％ of patients were extensively resistant to drugs. In the management plan of MDR-TB patients therapy， 56.17％ were treated in tuberculosis control institutions； referral to special hospital for treatment accounted for 14.81％； 22.22％ didn’t receive any treatment； other factors lead to a change in treatment or unable to continue to treat accounted for 6.79％. The incidence of ADR in MDR-TB patients was higher than suspected MDR-TB patients， there was statistical significance between 2 groups （P＜0.05）. After the following symptomatic treatment， all patients were improved. CONCLUSIONS： For patients with MDR-TB， according to disease condition， appropriate treatment management program can be found so as to improve therapeutic efficacy， reduce the incidence of ADR， control spreading and development of tubercle bacillus. |
| 期刊： | 2017年第28卷第32期 |
| 作者： | 杜德兵 |
| AUTHORS： | DU Debing |
| 关键字： | 耐多药结核病；治疗管理；药品不良反应；临床分析 |
| KEYWORDS： | MDR-TB； Treatment management； ADR； Clinical analysis |
| 阅读数： | 344 次 |
| 本月下载数： | 1 次 |
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