初始复治涂阳肺结核病例短程化疗方案的临床疗效和安全性  

Clinical efficacy and safety of short course chemotherapy for initial retreatment smear positive pulmonary tuberculosis

作　　者：孔雯[1] 刘巧[1] 宋红焕[1] 周扬[1] 丁晓艳[1] 陆伟[1] 张青[2] 肖和平[2] 竺丽梅[1] KONG Wen;LIU Qiao;SONG Hong-huan;ZHOU Yang;DING Xiao-yan;LU Wei;ZHANG Qing;XIAO He-ping;ZHU Li-mei(Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009,China)

机构地区：[1]江苏省疾病预防控制中心,南京210009 [2]上海肺科医院

出　　处：《江苏预防医学》2017年第6期637-639,共3页Jiangsu Journal of Preventive Medicine

基　　金：国家科技重大专项(2013ZX10003009)

摘　　要：目的探讨复治肺结核超短程化学治疗方案的临床疗效和安全性。方法 2013年6月—2015年12月在结核病定点医院连续纳入45例初次复治涂阳肺结核病例,采用临床随机对照按3∶1分试验组和对照组进行治疗。试验组35例,采取短程化疗方案5MfxRfb(Rft)PaZE;对照组10例,采取标准方案2SHREZ/6HRE或3HREZ/6HRE。比较两组的痰菌阴转率、治疗成功率及不良反应发生率。结果试验组、对照组2月末痰菌阴转率分别为91.43%,80.00%,疗程结束时痰菌阴转率分别为74.28%、70.00%,治疗成功率分别为74.28%、70.00%,不良反应发生率分别为14.29%、20.00%,差异均无统计学意义(P值均>0.05)。结论复治涂阳肺结核病例以短程化学治疗方案治疗,其治愈率、痰菌阴转率、不良反应发生率与标准化疗方案相当,但治疗时间较短,具有一定的临床意义。Objective To investigate the clinical efficacy and safety of a new short course chemotherapy for retreatment tuberculosis cases.Methods From Jun2013to Dec2015,a total of45initial smear positive tuberculosis cases were enrolled consecutively in the designated hospitals.Patients were divided into experimental group and control group through randomized controlled clinical trial with the ratio of3∶1.The35patients of experimental group were treated with short course chemotherapy5MfxRfb(Rft)PaZE.The10patients of control group were treated with program2SHREZ/6HRE or3HREZ/6HRE.Sputum negative conversion rate,treatment success rate and incidence of adverse reactions were compared between the two groups.Results The negative conversion rate of sputum at the end of the second month of the experimental group and the control group was91.43%and80.00%,respectively.The negative conversion rate of sputum at the end of treatment was74.28%and70.00%,respectively.The successful treatment rate was74.28%and70.00%respectively.The incidence of adverse reactions was14.29%and20.00%,respectively.No significant difference were observed between two groups(all P>0.05).Conclusion The successful treatment rate,sputum negative conversion rate and adverse reaction rate of retreatment smear positive pulmonary tuberculosis patients with short course chemotherapy were similar to those of standard chemotherapy treatment.However,the shorter treatment time had certain clinical significance.

关 键 词：肺结核 复治 短程化疗方案 临床试验 

分 类 号：R52[医药卫生—内科学]