Tuberculosis (TB) is an infectious disease that poses a serious threat to human health. Rifampin (RIF) is an important first-line anti-TB drug, and rifampin resistance (RIF-R) is a key factor in formulating treatment regimen and evaluating the prognosis of TB. Compared with other drugs resistance, the RIF-R mechanism of Mycobacterium tuberculosis (M. tuberculosis) is one of the clearest, which is mainly caused by RIF resistance-related mutations in the rpoB gene. This provides a convenient condition for developing rapid detection methods, and also an ideal object for studying the general drug resistance mechanisms of M. tuberculosis. This review focuses on the mechanisms that influence the RIF resistance of M. tuberculosis and related detection methods. Besides the mutations in rpoB, M. tuberculosis can decrease the amount of drugs entering the cells, enhance the drugs efflux, and be heterogeneous RIF susceptibility to resist drug pressure. Based on the results of current researches, many genes participate in influencing the susceptibility to RIF, which indicates the phenomenon of M. tuberculosis drug resistance is very complex.

结核病（TB）是一种严重威胁人类健康的传染病。利福平（RIF）是重要的一线抗结核药物，利福平耐药（RIF-R）是制定治疗方案和评估结核病预后的关键因素。与其他耐药性相比，结核分枝杆菌（M. tuberculosis）的RIF-R机制是最清楚的一种，主要是由rpoB基因中与RIF耐药相关的突变引起的。这为发展快速检测方法提供了便利条件，也是研究结核分枝杆菌一般耐药机制的理想对象。本综述侧重于影响 RIF 抗性的机制结核分枝杆菌及相关检测方法。除了rpoB的突变外，结核分枝杆菌还可以减少进入细胞的药物量，增加药物外排，并通过异质RIF易感性抵抗药物压力。从目前的研究结果看，许多基因参与影响了对RIF的易感性，说明结核分枝杆菌的耐药现象十分复杂。