耐多药肺结核病124例近期疗效观察  

OBSERVATION OF CURATIVE EFFECT IN THE NEAR FUTURE OF 124 CASES WITH MULTI DRUG RESISTANT PULMONARY TUBERCULOSIS

作　　者：金关甫[1] 林明贵[1] 王巍[1] 王安生[1] 刘金伟[1] 王仲元[1] 

机构地区：[1]解放军第309医院

出　　处：《解放军医学杂志》2001年第2期119-120,共2页Medical Journal of Chinese People's Liberation Army

摘　　要：自 1996年 1月～ 1999年 6月对住院的 12 4例耐多药结核病治疗结果进行了分析。本组病例均系复治病例 ,平均病程 5 .84年 ,其中浸润型肺结核 78例 ,慢性纤维空洞型肺结核 46例。应用匡氏培养基培养出人型结核杆菌 ,并做药敏试验 ,其中耐 2药占 2 0 .16 % ,耐 3药占 2 5 .0 % ,耐 4药占 2 0 .9% ,耐 5药及以上占 33.7%。应用卡那霉素 (K)、氧氟沙星 (O)、对氨基水杨酸钠 (P)为基础化疗方案 ,加用 1或 2种未曾应用过的抗痨药物 ,平均治疗 3.3个月。结果显示 ,痰菌转阴率为 6 6 .9% ,病灶吸收好转率为 72 .6 % ,空洞治疗有效率为 5 0 .0 % ,疗效较好 ,治疗过程中未出现严重的毒副作用。笔者认为KOP组成的化疗方案对细胞内外的结核菌都有杀灭作用 ,3药联合协同作用好 ,药物副作用不多 ,是治疗多耐药结核病的较好化疗方案。The curative effect on 124 cases with multi drug resistant pulmonary tuberculosis from January 1996 to June 1999 was reported.All the cases, with an average history of 5.84 years, were recurrent ones. They included 78 cases of infultative pulmonary tuberculosis,46 cases of chronic fibrocavitative pulmonary tuberculosis. Sputum of all the cases was cultured for Mycobacterium hominis tuberculosis with Kuang`s culture medium and drug susceptibility test was done. As a result, the drug resistant rate to 2 drugs, 3 drugs,4 drugs, 5 drugs and more were 20.16%,25.0%,20.9%,33.72% respectively.The authors added 1～2 kinds of anti TB drugs never used before in each case to KOP (Kanamycin, Ofloxacin, Sodium Aminosalicylate),with a mean 3.3 months treating course. The sputum negative conversion rate was 66.9%,foci absorption rate was 72.6%, cavity close up 50.0% . There wasn′t any serious adverse effect encounted. It suggest that KOP synergetic bacteriocidal to Mycobacterium tuberculosis either inside or outside cells, with fewer side effect, is a good regimen for multi drug tuberculosis treatment.

关 键 词：多药抗药性 肺结核 药物治疗 疗效 

分 类 号：R521.05[医药卫生—内科学] R978.3[医药卫生—临床医学]