摘要
目的探讨噬菌体检测法（Pha B）快速检测老年复治肺结核合并糖尿病患者结核分支杆菌对异烟肼（H）、利福平（R）、乙胺丁醇（E）和链霉素（S）4种一线抗结核药物的耐药性,分析其临床应用价值。方法应用Pha B法检测65例老年复治肺结核合并糖尿病患者结核分枝杆菌对4种一线抗结核药物的耐药性。结果老年复治肺结核合并糖尿病患者总耐药率为50.00%,单纯老年复治肺结核患者的总耐药率为34.88%,2组差异无统计学意义（χ~2=1.39,P=0.24）;2组耐多药率和耐S率差异有统计学意义（χ~2=5.25,P=0.02;χ~2=5.24,P=0.02）。老年复治肺结核合并糖尿病患者空腹血糖≥7.10 mmol/L组耐药率为69.23%,高于空腹血糖〈7.1 mmol/L组的22.22%,2组差异有统计学意义（χ~2=4.70,P=0.03）。结论老年复治肺结核合并糖尿病患者耐多药率和耐S率高,尤其是血糖≥7.10 mmol/L者。Pha B法能快速检测结核分枝杆菌耐药性,指导临床用药。
Objective To explore the drug resistance of mycobacterium tuberculosis to the four first-line anti-TB drugs,including isoniazid（ H）,rifampicin（ R） and ethambutol（ E）,streptomycin（ S）,in the elderly patients with retreatment tuberculosis complicated with diabetes,by using phage biological amplification（ PhaB）. Methods PhaB was used to detect the drug resistance of the mycobacterium tuberculosis to the four first-line anti-TB drugs in 65 elderly cases of retreatment tuberculosis complicated with diabetes. Results The total drug resistance rate of the elderly patients with retreatment of pulmonary tuberculosis complicated with diabetes was 50. 00%,compared with 34. 88% in the elderly patients retreatment pulmonary tuberculosis without diabetes（ χ~2= 1. 39,P = 0. 24）; There were significant differences in multi-drug resistance ratio and streptomycin resistance between two groups（ χ~2= 5. 25,P = 0. 02; χ~2= 5. 24,P = 0. 02）. The resistant rate was 69. 23% in the elderly patients with retreatment pulmonary tuberculosis with a blood glucose level≥7. 10 mmol / L,compared with 22. 22% in the patients with a blood glucose level less than 7. 10 mmol / L（ χ~2= 4. 70,P = 0. 03）. Conclusions Multi-drug resistance ratio and streptomycin resistance is high in the elderly patients with retreatment pulmonary tuberculosis,especially in the patients with a blood glucose level≥7. 10 mmol / L. PhaB method can rapidly detect the drug resistance of mycobacterium tuberculosis,and can guide the clinical medication.
出处
《实用老年医学》
CAS
2015年第12期1021-1024,共4页
Practical Geriatrics
基金
山东省医药卫生科技发展计划项目(2013WS0146)
关键词
噬菌体扩增法
复治肺结核
糖尿病
耐药
老年人
phage biological amplification
retreatment tuberculosis
diabetes
drug resistance
aged
