含高剂量异烟肼化疗方案对药物敏感复治肺结核患者的疗效评价  

Effectiveness of high-dose isoniazid regimen for treatment of TB in drug-susceptible retreated patients with pulmonary tuberculosis

作　　者：陈瑜晖 林伟斌 刘萍萍 温文沛 周杰 张锡林 钟倩红 何凯立[3] 陈涛 郭翠弟 钟耐容 陈丽英 蔡雪珍 钟球 周琳 CHEN Yu-hui LIN Wei-bin LIU Ping-ping WEN Wen-pei ZHOU Jie ZHANG Xi-lin ZHONG Qian-hong HE Kai-li CHEN Tao GUO Cui-di ZHONG Nai-rong CHEN Li-ying CAI Xue-zhen ZHONG Qiu ZHOU Lin(Centre for Tuberculosis Control of Guangdong Province, Guangzhou 510630, China)

机构地区：[1]广东省结核病控制中心,广州510630 [2]广东省佛山市第四人民医院 [3]广州市胸科医院一门诊

出　　处：《中国防痨杂志》2017年第7期761-764,共4页Chinese Journal of Antituberculosis

基　　金：广东省医学科研基金项目（C2015010）;“十二五”国家科技重大专项（2013ZX10003009-007）

摘　　要：目的 探讨采用含高剂量异烟肼的抗结核药物治疗方案对药物敏感复治肺结核患者的疗效.方法 将82例对药物敏感的复治肺结核患者按就诊先后顺序采用随机数字表法,分为试验组及对照组,试验组（40例）采用含高剂量异烟肼的抗结核药物治疗方案,对照组（42例）实行标准化抗结核药物治疗方案进行治疗.比较两组患者治疗效果、不良反应发生率及复发情况.两组计数资料和率的比较采用χ^2检验或Fisher精确概率法进行比较,以P＜0.05为差异有统计学意义.结果 完成治疗后试验组患者胸部X线摄影显示病灶吸收率为72.5％（29/40）,对照组病灶吸收率为52.4％（22/42）,两者比较差异无统计学意义（χ^2=3.52,P=0.060）.试验组患者服药后药物不良反应发生率为15.0％（6/40）,略高于对照组（11.9％,5/42）,但两组不良反应发生率比较差异无统计学意义（χ^2 =0.17,P=0.681）.试验组患者临床治愈率和治疗成功率分别为77.5％（31/40）和85.0％（34/40）,对照组分别为57.1％（24/42）和64.3％（27/42）,两组比较差异均有统计学意义（χ^2=3.84,P=0.049;χ^2 =4.61,P=0.032）.患者完成治疗后6个月随访,试验组复发率为0.0％（0/34）,而对照组复发率为3.7％（1/27）,但两组患者复发率比较差异无统计学意义（Fisher精确检验,P=1.000）.结论 含高剂量异烟肼的抗结核药物治疗方案能有效提高复治肺结核患者的治疗效果.Objective To evaluate the effectiveness of high-dose isoniazid regimen for treatment of tuberculo sis （TB） in the retreated patients with TB.Methods A total of 82 drug-susceptible retreated patients were recruited into the study.They were randomly divided into high-dose isoniazid regimen group （experimental group） and standard retreatment regimen group （control group）.The final sizes of the study groups were 40 and 42 for experi mental group and control group respectively.The treatment outcome,drug adverse effect and relapse of the two groups were analyzed.The quantitative data were analyzed by Chi-square test or Fisher＆#39;s exact test,P〈0.05 was considered statistically significant.Results The rate of chest lesions absorption assessed through chest radiograph was 72.5% （29/40） for experimental group and 52.4% （22/42） for control group.There was no statistical significance between two groups （χ^2 =3.52,P=0.060）.The rate of drug adverse reactions was 15.0% （6/40） in experimental group which was higher than the control group （11.9 %,5/42）,but with no statistical significance between two groups （χ^2 =0.17,P=0.681）.The cure rate and treatment success rate in experimental group were 77.5% （31/40） and 85.0% （34/40） respectively,which were higher than those in control group （57.1 %,24/42;64.3%,27/42）.The differences were statistically significant （χ^2 =3.84,P=0.049;χ^2 =4.61,P=0.032）.The relapse rates at six months after treatment completion was 0.0% （0/34） and 3.7% （1/27） respectively,but there was no statistical significance （Fisher test,P =1.000）.Conclusion The high-dose isoniazid regimen can effectively improve the effectiveness of retreated TB patients.

关 键 词：结核 肺 异烟肼 剂量效应关系 药物 结果与过程评价(卫生保健) 

分 类 号：R521[医药卫生—内科学]