含利福布汀方案治疗缓慢生长型非结核分枝杆菌肺病的短期疗效分析  

Short-time efficacy of regimen containing rifabutin in patients with slowly growing mycobacterium lung disease

作　　者：孙雯雯[1] 楼海[1] 孙勤[1] SUN Wen-wen;LOU Hai;SUN Qin(Clinic and Research Center of Tuberculosis,Shanghai Key Laboratory of Tuberculosis,Shanghai Pulmonary Hospital,Tongji University School of Medicine,Shanghai 200433,China)

机构地区：[1]同济大学附属上海市肺科医院结核病临床研究中心上海市结核病肺重点实验室,200433

出　　处：《中国防痨杂志》2018年第9期948-953,共6页Chinese Journal of Antituberculosis

基　　金：上海市浦江人才计划（16PJ19041）;上海市西医引导项目（17411969300）

摘　　要：目的探讨含利福布汀（rifabutin，Rfb）的治疗方案对缓慢生长型非结核分枝杆菌（slowly growing mycobacterium，SGM）肺病的短期疗效和安全性。方法收集上海市肺科医院2013年1月至2014年12月期间住院确诊且规律治疗并参加随访的SGM肺病患者124例，其中治疗方案中含有Rfb的患者56例作为含Rfb组，同期确诊且治疗方案中不含Rfb的68例患者作为对照组，两组进行临床疗效和安全性的比较，两组间计量资料采用方差分析，率的比较采用卡方检验，P〈0．05为差异具有统计学意义。结果（1）细菌学疗效评价：治疗3个月末两组痰菌阴转率分别为含Rfb组28．57％（16／56），对照组26．47％（18／68），差异无统计学意义（X^2=0．452，P=0．512）；6个月末痰菌阴转率分别为含Rfb组57．14％（32／56）和对照组51．47％（35／68），差异无统计学意义（X^2=1．125，P=0．112）；治疗12个月末含Rfb组痰菌阴转率（78．57％，44／56）明显高于对照组（69．12％，47／68），差异有统计学意义（X^2=3．089，P=0．008）。（2）影像学疗效评价：病灶吸收率含Rfb组（75．00％，42／56）明显高于对照组（60．29％，47／68），差异有统计学意义（X^2=4．523，P=0．009）；空洞吸收率分别为含Rfb组（73．21％，41／56）和对照组（63．24％，43／68），差异无统计学意义（X^2=1．952，P=0．094）；两组临床疗效对比，含Rfb组好转率（73．21％，41／56）明显高于对照组（60．29％，41／68）（X^2=3．412，P=0．012）。结论含Rfb方案可加速SGM肺病患者的痰菌阴转和病灶的吸收。Objective To observe the short-time efficacy and safety of regimen containing rifabutin （Rfb） in patients with slowly growing mycobacterium （SGM） lung disease. Methods One hundred and twenty-four inpatients with SGM lung disease treated with standard regimen and regular management who hospitalized in shanghai pulmonary hospital from January 2013 to December 2014 were enrolled in this retrospective study. Fifty-six patients were treated with Rfb regimen as observation group and 68 patients were treated without Rfb regimen as control group. The treatment outcome and drug adverse reaction rates were compared between the two groups. Results （1） The sputum negative conversion rate in the end of 12 months in the observation group was （78. 57%,44/56） significantly higher than that in the control group （69.12%, 47/68） （X^2=3. 098, P=0. 008）. There were no statistic significance of the sputum negative conversion rates in the end of 3 months and 6 months between the two groups （all P value 〉0.05）. （2） The focal absorption rate （75.00 %, 42/56）in the observation group was significantly higher than that （60.29%, 41/68） in the control group （X^2=4. 523, P=0. 009）. There was no statistic significance of the lung cavity closure rate between the two groups （X^2=1.952, P=0. 094）. Compared with the control group on the focus absoption rate （60.29%, 41/68）, the observation group （73.21%, 41/56） had a better efficacy （X^2=3. 412, P=0. 012）. Conclusion Regimen containing Rfb shows a better short-time efficacy in the treatment of patients with SGM lung disease. However, the drug adverse reaction rates in observation group are higher than those in control group.

关 键 词：分枝杆菌感染 非典型性 利福布汀 药物疗法 联合 临床方案 疗效比较研究 

分 类 号：R563[医药卫生—呼吸系统]