短程化疗间歇疗法治疗529例涂阳肺结核效果  

Effectiveness of Intermittent Short-course Chemotherapy for Tuberculosis in 529 Smear-positive Cases

作　　者：杨年忠[1] 郑丽君[2] 

机构地区：[1]台州市椒江区疾病预防控制中心结核病防治中心,浙江318000 [2]浙江省台州医院

出　　处：《中国预防医学杂志》2008年第4期281-283,共3页Chinese Preventive Medicine

摘　　要：目的了解短程化疗间歇疗法治疗效果,分析治疗失败原因,探讨初治涂阳肺结核空洞最佳化疗方案。方法初治涂阳肺结核化疗方案:2H3R3Z3E3/4H3R3;复治涂阳肺结核化疗方案:2S3H3R3Z3E3/6H3R3E3。使用抗结核板式组合药,门诊医师指导下不住院家庭督导化疗。结果初治涂阳肺结核446例,化疗2月末、3月末痰菌阴转率分别为86.32%和89.46%。复治涂阳肺结核83例,痰菌阴转率分别为73.49%和86.75%。涂阳肺结核529例,平均治愈率86.39%,其中,初治涂阳治愈率89.01%,复治涂阳治愈率72.29%。初治涂阳空洞组170例,治愈率82.94%,初治涂阳无空洞组276例,治愈率92.75%,两组差异有统计学意义(P=0.001)。复治涂阳空洞组34例,治愈率70.59%,复治涂阳无空洞组49例,治愈率73.47%,两组差异无统计学意义(P=0.75)。结论2H3R3Z3E3/4H3R3方案用于初治涂阳肺结核无空洞者是适宜的;初治涂阳肺结核空洞者,宜选择2HRZE(S)/4HR或2HRZE(S)/4HRE方案。Objective To explore the effects of short- course intermittent therapy, the causes of treatment failure and the optimal chemotherapy for newly-diagnosed smear-posltlve patients with cavitary pulmonary tuberculosis. Methods Chemotherapies for initially-treated and re -treated smear-positive tuberculosis were 2H3R3Z3E3/4H3R3 and 2S3H3R3Z3E3/6H3R3E3 , respectively. A supervised ambulatory treatment program was conducted and the anti - tuberculosis fixed- dose combination tablets were used. Results For 446 initially - treated smear - positive tuberculosis cases, the sputum negative conversion rates were 86. 32% at the end of 2 months of treatment, and 89. 46% at the end of 3 months. For 83 re - treated smear - positive cases, the sputum negative conversion rates at the end of 2 months and 3 months of treatment were 73.49% and 86. 75% , respectively. For total 529 cases of smear - positive tuberculosis, the average cure rate was 86. 39% , and the rates were 89. 01% and 72. 29% respectively for initially - treated and re - treated cases. Significant difference was found in cure rate between the group of initially - treated cavitary tuberculosis （82. 94% ） and the group of initially - treated cavitary tuberculosis （92.75%） , while no significant difference was found in cure rate between the group of re - treated non - cavitary tuberculosis （70. 59% ） and the group of re - treated non - cavitary tuberculosis （73.47%）. Conclusion The chemothera- py of 2H3R3Z3E3/4H3R3 is optimal for patients with initially - treated smear - positive non - cavitary tuberculosis, while for those with cavitary tuberculosis, the chemotherapy of 2HRZE （S） /4HR or 2 HRZE （S） /4HRE may be suitable.

关 键 词：结核 肺 涂阳 全程间歇疗法 短程化疗 

分 类 号：R521[医药卫生—内科学]