不同复治涂阳肺结核患者全程间歇短程化疗效果评价  

Effectiveness of short course intermittent regimen on different categories of retreated patients with pulmonary tuberculosis

作　　者：王雪静[1] 戴元生[1] 曹继平 张联英 张本[1] 端木宏谨[1] 李国刚 朱俊卿 陈海峰 刘宇红[1] 苏智[1] 杜昕[1] 董彬 弓彦廷 李仰 

机构地区：[1]卫生部结核病控制中心,北京101149 [2]河北省结核病防治所 [3]石家庄市结核病防治所 [4]邯郸市结核病防治所

出　　处：《中华结核和呼吸杂志》2001年第8期472-476,共5页Chinese Journal of Tuberculosis and Respiratory Diseases

摘　　要：目的　评价标准复治涂阳短程化疗方案对复发、初治失败及其它复治 3组不同复治涂阳肺结核患者的治疗效果 ,为进一步提高复治肺结核患者的疗效提供依据。方法　选取复治涂阳肺结核患者 3 0 3例 ,分为复发 ( 87例 )、初治失败 ( 2 1例 )及其它复治 ( 1 95例 ) 3组。所有入选病例在治疗前均做痰结核分支杆菌培养及药敏试验。对 3组复治涂阳肺结核患者均采用同一复治涂阳短程化疗方案 ,即 2～ 3H3R3Z3E3S3/ 5～ 6H3R3E3进行治疗 ,观察 3组复治患者的耐药情况及治疗效果。结果　 3组复治涂阳肺结核患者在耐药水平及疗效上均无显著性差异 (P >0 0 5)。其它复治患者中 ,既往累计治疗时间超过 1 2个月者的耐药率 ( 79 5% )明显高于既往累计治疗时间少于 1 2个月者 ( 59 8% )( 0 0 1 <P <0 0 5) ,治疗成功率前者 ( 69 4 % )明显低于后者 ( 90 4 % ) (P <0 0 0 1 )。敏感病例的治疗成功率 ( 93 3 % )明显高于耐药病例 ( 75 3 % ) (P <0 0 0 1 )。Objective To evaluate the efficacy of short course intermittent regimen in the different categories of retreated patients with tuberculosis. Methods 303 ret reated patients with smear-positive pulmonary tuberculosis were recruited for t he study T hey were divided into three groups based on the history of tuberculosis and anti -tuberculosis treatment 87 were in relapse group,21 in failure group (failur e after the initial treatment) and 195 in other retreatment group Sputum Mycobacterium tuberculosis culture and drug susceptibility test were condu cted before treatment The same retreatment regimen (2～3H 3R 3Z 3E 3S 3/ 5～6H 3R 3E 3) was employed for all three groups of patients Drug resistance and the outcome s of three groups of retreatment tuberculosis were analysed. Results The drug resistance rates and e fficacy of retreatment showed no statistical difference among three groups (P >0 05) In other retreatment group,the drug resistant rate in patients who recei ve d anti-TB drugs for more than 12 months (795%) was significantly higher than th ose for less than 12 months (598%,001<P<005) Meanwhile,the succe ssful rate s of treatment were 694% vs 904% between two subgroups,being significantly di fferent (P<0001) The successful treatment rate in susceptible patients ( 933%) was significantly higher than that in drug resistant patients (753%,P<0 01). Conclusion To enhance the efficacy of anti-TB the rapy in drug-resistant patients is the key of improving the outcome of retreate d patients receiving short course intermittent regimen

关 键 词：肺结核 药物耐受性 治疗 药物疗法 短程化疗 效果评价 

分 类 号：R521[医药卫生—内科学]