利福喷丁在脊椎结核短程化疗中的应用  

Short-course Chemotherapy with Rifapentine(RFT) in Tuberculosis of the Spine

作　　者：吴启秋[1,2,3] 梁平天 张树安 程宏[1,2,3] 孙洪刚 郭梅秀 

机构地区：[1]北京结核病胸部肿瘤研究所 [2]河北省结核病防治院 [3]山东潍坊第二人民医院

出　　处：《中华骨科杂志》1998年第1期17-19,共3页Chinese Journal of Orthopaedics

摘　　要：１９９０～１９９２年三个医院按规定的选例标准共收治脊椎结核７２例。男２６例，女４６例。年龄２０～６０岁，平均３８．９岁。病变分别位于胸椎（２２例）、胸腰椎（７例）以及腰椎（４３例）。受累椎体平均为２．２个。这些病例随机分配到两个化疗方案组：２ＳＨＲＺ／６Ｈ３Ｚ３Ｌ１（８个月），２ＳＨＲＺ／５Ｈ３Ｚ３Ｌ１（７个月），经２个月化疗强化期之后，以长效的利福喷丁（ＲＦＴ）代替利福平（ＲＦＰ）。除９例（１１％）单用化疗外，所有病例在化疗强化期内均施行病灶清除术。有３例因药物副作用而改变方案，另３例因脊椎病变而延长３个月疗程。化疗完成后，６８例经２２～４２个月随访（平均３６个月）获得满意效果。Ｘ线摄片椎间骨性愈合者４４例，纤维愈合者２４例，无１例病变复发，疗效满意。结果提示：（１）两个化疗方案治疗反应好，其主要副作用为肝功损害，发生率较低（４％），（２）两个化疗方案效果好且相仿，（３）根据临床资料和作者试验数据，在２个月的强化期之后，可以用ＲＦＴ代替ＲＦＰ，且取得良好的疗效。eventy-two cases of tuberculosis of the spine encountered from 1990 to 1992 in three hospitals were included in this study. The average age of the patients was 38.9 years (range 20 to 60 years).Fourty-six were women and 26 men. The lesions were situated in thoracic, thoracolumbar and lumbar regions in 22,7 and 43 cases respectively. The involved vertebrae averaged 2.2. The patients were allocated into two treatment regimens randomly:2 SHRZ/6 H 3 Z 3 L 1(8 Months), 2 SHRZ/5 H 3 Z 3 L 1(7 Months). RFT substituted for RFP after a twomonths initial intensive treatment period. All of the patients,except 9 cases (11%) treated by chemotherapy alone,operative debridement of spinal focus was performed within the intensive treatment period. In 3 cases the allocated regimens was modified for adverse reactions and another 3 cases had required prolongation of their allocated chemotherapy for 3 months because of spinal lesions. Sixtyeight patients had achieved a favourable status for 22 to 42 months followup (average 36 months) after completing the regimens. Xray films showed that bone fusion in 44 cases, fibrous healing in 24 cases and no relapse had occurred. The results of the study were encouraging: (1) the therapeutic response was favourable in both regimens and adverse reaction,mainly hepatic toxicity were rather lower (4%),(2) both regimens had identical high efficacy,(3) according to the clinical study and author laboratory data, RFT could substitute for RFP after a twomonths initial intensive treatment period.

关 键 词：药物疗法 脊椎结核 利福喷丁 

分 类 号：R529.205[医药卫生—内科学]