氯法齐明联合背景化疗方案治疗鸟-胞内分枝杆菌肺病的临床效果研究  

Study on clinical effect of clofazimine combined with background regimen in treatment of Mycobacterium avium-intracellulare complex lung disease

作　　者：姚戈 聂琦 陈南山 涂盛锦 周勇[1] 朱木新 肖璠 刘源 陈华[1] YAO Ge;NIE Qi;CHEN Nanshan;TU Shengjin;ZHOU Yong;ZHU Muxin;XIAO Fan;LIU Yuan;CHEN Hua(Wuhan Jinyintan Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology/Hubei Clinical Research Center for Infectious Diseases/Wuhan Research Center for Communicable Disease Diagnosis and Treatment of Chinese Academy of Medical Sciences/Joint Laboratory of Infectious Diseases and Health,Wuhan Institute of Virology and Wuhan Jinyintan Hospital,Chinese Academy of Sciences,Wuhan,Hubei 430023,China)

机构地区：[1]华中科技大学同济医学院附属武汉金银潭医院(耐药结核科)/湖北省传染病临床医学研究中心/中国医学科学院武汉传染性疾病诊治研究中心/中国科学院武汉病毒研究所&武汉市金银潭医院感染性疾病与健康联合实验室,湖北武汉430023

出　　处：《临床肺科杂志》2023年第12期1872-1877,共6页Journal of Clinical Pulmonary Medicine

基　　金：武汉市卫生和计划生育委员会医学科研项目(No.WX17Q28)。

摘　　要：目的研究是否在背景化疗方案中加入氯法齐明能够改善鸟-胞内分枝杆菌肺病患者的预后。方法我们在中国武汉开展了一项前瞻性、随机、对照研究,重点关注在背景化疗方案中加入氯法齐明,能否改善鸟-胞内分枝杆菌肺病患者的疗效。2018年1月至2020年12月期间在武汉市金银潭医院开始接受抗非结核分枝杆菌化疗方案治疗的鸟-胞内分枝杆菌肺病患者被随机分配到试验组和对照组。试验组接受包含氯法齐明的治疗方案,对照组接受不包含氯法齐明的治疗方案。结果治疗结束时,试验组的治愈率为66.67%(22/33),而对照组的治愈率为38.46%(15/39),两组比较差异有统计学意义(P<0.025)。试验组肺部病灶治疗后吸收有效率为69.70%(23/33),对照组肺部病灶治疗后吸收有效率为41.03%(16/39),两组比较差异有统计学意义(P<0.025)。试验组总的严重不良反应发生率为6.06%(2/33),对照组总的严重不良反应发生率为7.69%(3/39),两组比较差异无统计学意义(P>0.75)。结论在背景化疗方案中加入氯法齐明可改善鸟-胞内分枝杆菌肺病患者的预后。Objective To investigate whether adding clofazimine to background therapy can improve outcomes in patients with Mycobacterium avium-intracellulare complex(MAC)lung disease.Methods It conducted a prospective,randomized,controlled study in Wuhan,China.The focus was on whether the addition of clofazimine to background therapy could improve outcomes in patients with MAC lung disease.Patients with MAC lung disease who began treatment with an anti-nontuberculous mycobacterium regimen at Wuhan Jinyintan Hospital from January 2018 to December 2020 were randomly divided into the experimental group and the control group.The experimental group received a regimen containing clofazimine,and the control group received a regimen without clofazimine.Results At the end of treatment,the cure rate of the experimental group was 66.67%(22/33),while that of the control group was 38.46%(15/39),and the difference between the two groups was statistically significant(P<0.025).The absorption rate of lung lesions after treatment was 69.70%(23/33)in the experimental group and 41.03%(16/39)in the control group,and the difference between the two groups was statistically significant(P<0.025).The total incidence of serious adverse reactions was 6.06%(2/33)in the experimental group and 7.69%(3/39)in the control group,and there was no statistical significance between the two groups(P>0.75).Conclusion Adding clofazimine to the background regimen can improve the outcome of patients with MAC lung disease.

关 键 词：氯法齐明 联合 背景化疗方案 鸟-胞内分枝杆菌肺病 预后 

分 类 号：R563[医药卫生—呼吸系统]