肺结核强化治疗期类赫氏反应16例临床分析  

A clinical analysis of 16 cases of Jarisch-Herxheimer-like reaction during the intensive chemotherapy for tuberculosis

作　　者：朱柏[1] 杨岚[1] 吴笛[1] 

机构地区：[1]西安交通大学医学院第一附属医院呼吸内科,西安710061

出　　处：《陕西医学杂志》2008年第9期1163-1164,共2页Shaanxi Medical Journal

摘　　要：目的:探讨肺结核强化治疗期出现类赫氏反应的机制、治疗及转归。方法:回顾性分析我科收住的肺结核病人中诊断的16例类赫氏反应的临床症状、X线表现及治疗、转归。结果:本组16例病人均为初治病例,40岁以下13例(占81.3%),类赫氏反应发生时间为抗痨治疗后20~180d,其中<30d5例,占31.3%,31~60d9例,占56.3%;61~90d1例,占6.3%,91~180d1例,占6.3%。主要表现为原发结核病灶增大、新病灶出现、浆膜腔积液及淋巴结肿大。加用强的松治疗者类赫氏反应持续时间1~3周6例,占37.5%;3周至2月4例,占25%;未加用强的松治疗者持续1~2月消失6例,占37.5%。结论:类赫氏反应是在肺结核强化治疗期间出现的病灶暂时性恶化,继续原化疗方案治疗,必要时加用激素治疗,能取得较好疗效。Objective:To study the pathogenesis, treatment and outcome of Jarisch-Herxheimer-like reaction during the intensive chemotherapy for tuberculosis. Methods: 16 patients with tuberculosis diagnosed as Jarisch-Herxheimer-like reaction were reviewed retrospectively. The clinical manifestation, image of chest X-ray films, treatment and outcome were studied. Results: Of 16 patient treated initially, 13 patients<40y(81.3%).Patients developed Jarisch-Herxheimer-like reaction during 20～180d after chemotherapy, wh...

关 键 词：结核 肺/诊断 肺/药物疗法 抗结核药/副作用 

分 类 号：R521[医药卫生—内科学]