| Objective To analyze the drug resistance to first-line and second-line anti-tuberculosis drugs in those diabetic patients with initially-treated pulmonary tuberculosis and their resistance rates at different blood levels of glycosylated hemoglobin (HbA1c). Methods 296 patients with initially-treated pulmonary tuberculosis and positive sputum culture results, admitted in our hospital between Jan 2017 and Dec 2017, were collected and divided into two groups according to their diabetes history. 126 cases with diabetes and initially-treated pulmonary tuberculosis were set as the study group, and other 170 cases only with initially-treated pulmonary tuberculosis were included in the control group. Their resistance rates to four kinds of first-line drugs (isoniazid, rifampicin, ethambutol and streptomycin) and five kinds of second-line drugs (amikacin, capreomycin, levofloxacin, sodium aminosalicylate and protionamide) between the two groups were compared. Meanwhile, patients in the study group were further divided into three subgroups according to their blood HbA1c levels:subgroup with HbA1c < 7%, subgroup with 7% ≤ HbA1c < 9% and subgroup with HbA1c ≥ 9%. Their resistance rates to the above mentioned four first-line drugs and five second-line drugs among different HbA1c levels were compared within the study group. Results The rates of total and single drug resistance,The resistance rate to isoniazid in the study group was much higher than that in the control group, and difference between them was statistically significant (P<0.05). Although multidrug resistance and polyresistance, together with the resistance rate to any of rifampicin, streptomycin, ethambutol, amikacin, capreomycin, levofloxacin, sodium aminosalicylate and protionamide, in the study group were all higher than those in the control group, but no significant difference was found between the two groups (P>0.05). In the study group, their resistance rates at different blood HbA1c levels were 13.79%, 34.15% and 85.19%, respectively, and differences among them were statistically significant (all P<0.05). Conclusion The drug resistance rate to anti-tuberculosis drugs would increase in those diabetic patients with initially-treated pulmonary tuberculosis, and the higher their HbA1c levels are, the higher their drug resistance rates would be. |
