静脉联合治疗和延长强化期治疗对复治肺结核疗效的影响  

Efficacy of Intravenous co-therapy and extended initial phase therapy on retreatment pulmonary tuberculosis

作　　者：顾瑾[1] 肖和平[1] 王凯[1] 唐神结[1] 

机构地区：[1]同济大学附属上海市肺科医院,上海200433

出　　处：《中国防痨杂志》2009年第12期713-717,共5页Chinese Journal of Antituberculosis

基　　金：上海市公共卫生优秀人才培养计划(08GWQ093)

摘　　要：目的探讨静脉联合治疗和延长强化期治疗对初次复治肺结核患者的临床应用价值。方法研究对象随机分为治疗组1和治疗组2,治疗组1采用2AHPRZE/6HRE方案,在强化期间给予静脉联合治疗,治疗组2采用2SHRZE/1HRZE/5HRE方案。结果可评价病例治疗组1(132例)在1月内可有效改善咳嗽、咳痰、发热、乏力症状,症状消失率为76.23%～87.50%。治疗1月时,涂阳阴转率为80.90%,高于治疗组2(95例)的59.02%,P<0.01,培阳阴转率为73.42%,高于治疗组2的56.14%,P<0.05;疗程结束时后,2组的阴转率差异无统计学意义。治疗组1的病灶吸收显效率,疗程结束时可达73.48%,明显高于治疗组2的51.58%,P<0.01。治疗1月时,治疗组1的病灶空洞缩小率为66.07%,明显高于治疗组2的36.36%,P<0.01;疗程结束时,其病灶空洞闭合率为62.50%,高于治疗组2的36.36%,P<0.05。结论强化期静脉联合治疗或延长强化期治疗复治肺结核可望提高疗效,前者效果更佳。Objective To study the clinical value of intravenous co-therapy and extended initial phase therapy in first retreatment pulmonary tuberculosis patients. Methods The cases were ran- domly divided into therapy group 1（132 eases） and therapy group 2 （95 cases）, group 1 was treated with 2AHPRZE/6HRE, and received intravenous co-therapy in initial phase, while group 2 was treated with 2SHRZE/1HRZE/5HRE. Results Within 1 month, symptoms were effectively alle- viated in group 1. The symptoms of fever, cough, sputum and weak were greatly improved, the dis- appeared rate was from 76.23% to 87.50%, P〈0.01. After 1 month of treatment, the tuberculo- sis sputum smear negative conversion rate in group 1 was 80.90%, while the group 2 was 59.02%, P〈0.01. The culture negative conversion rate was 73.42%, which was higher than 56.14% in group 2, P〈0.05. Although the final conversion rate in group 1 was hi there was no statistical difference between the two groups. Throughou the effective rate of focus absorption in group 1 was 73.48% （51. 58%）,P〈0. 01. After 1 month of treatment, the rate of which cavity gher than that in group 2, t the course of treatment, was better than group 2 shrankage in group 1 was 66.07% ,while group 2 was 36.36% ,P〈0.01. At the end of treatment, the rate of cavity closure was 62.50 % ,higher than that in group 2,which was 36.36 % ,P〈0.05. Conclusions Both intra- venous co-therapy and extended initial phase therapy can improve the therapeutic effect, the former is better.

关 键 词：结核 肺/药物疗法 输注 静脉内 治疗结果 

分 类 号：R521[医药卫生—内科学] R472.9[医药卫生—临床医学]