摘要
目的评价治疗新方案和国家统一的标准化疗方案对初治涂阳老年肺结核患者的疗效。方法本研究采用前瞻性研究与回顾性研究相结合的方法,于2014年1月1日至2016年8月31日选择北京市14个收治肺结核的结核病定点医疗机构.共收集符合本研究纳入标准的初治涂阳老年肺结核患者302例.根据课题实施方案的要求分为观察组和对照组,其中2015年8月1日至2016年8月31日纳入患者63例作为观察组,应用6L2HELfx方案进行治疗;对照组为2014年1月1日至2015年1月31日各结核病定点医疗机构登记管理的使用国家统一的标准化疗方案2RHZE/4RH治疗的患者239例。分析比较两组患者在治疗疗程完成情况、痰菌阴转情况、药物不良反应发生情况及治疗转归等方面的差异。结果观察组疗程完成率为90.5%(57/63),高于对照组疗程完成率为79.5%( 190/239)(F=4.034, P=0.045);观察组治疗2个月末痰菌阴转率为87.0%(47/54),高于对照组治疗2个月末痰菌阴转率81.6%(155/190),但组间差异无统计学意义(X^2=0.879,P=0.349)。观察组不良反应发生率为46.0%(29/63),明显低于对照组不良反应发生率65.3%(156/239)(X^2=7.777,P=0.005 )。观察组治疗成功(治愈+完成疗程)率为90.5%(57/63),高于对照组77.4%(185/239)(X^2=5.350,P=0.021)。结论含L及Lfx的治疗方案与标准化疗方案比较,初治涂阳老年肺结核患者能较好地坚持完成疗程并获得良好的治疗效果,治疗成功率高,不良反应较少。
Objective To evaluate the efficacy of the new treatment regimen versus the standardized scheme for the initial treatment of smear-positive tuberculosis in the elderly. Methods A total of 302 elderly patients meeting the inclusion and exclusion criteria were selected from 14 tuberculosis-designated medical institutions in Beijing. The patients received the initial treatment of smear-positive tuberculosis from January 2014 to August 2016 in the combined prospective and retrospective study. All patients were divided into observation group(n= 63)receiving treatment with 6L2HELfx regimen from August 1,2015 to August 31,2016, and control group (n=239) receiving treatment with 6L2 HELfx regimen from January 1,2014 to January 31,2015. The nation-unified standard chemotherapy regimen 2RHZE/4RH was used in tuberculosis medical service institutions for all patients.The differences between the two groups were analyzed and compared in the completion of treatment, negative conversion of sputum culture or smear, adverse drug reactions and treatment outcome.Results The completion rate of long-course therapy was significantly higher in the observation group than in control group [90.5%( 57/63 ) vs.79.5 %( 190/239 ),=4.034 , P=0.045].The rate of negative conversion of sputum culture or smear at the end of the 2nd month was higher in the observation group than in control group, but had no significant difference[87.0%(47/54) vs.81.6%(155/190)=0.879,P=0.349].The incidence of adverse reactions was much lower in observation group than in control group [ 46.0%( 29/63 ) 65.3 %( 156/239 ), X^2 = 7.777, P =0.005].The success rate of treatment (cure or completion of long-course therapy) was higher in observation group than in control group [ 90.5%( 57/63 ) vs.77.4 %( 185/239 ), X^2 = 5.350, P =0.021].Conclusions As compared with the standard chemotherapy regimen, the L and Lfxcontaining treatment regimen has better effects, higher success rate of treatment and less adverse reactions in elderly patients with the initial treatment of smear-po
作者
李波
曹文利
裴宁
李亚敏
罗萍
高志东
洪峰
武文清
王俊栋
屠德华
Li Bo;Cao Wenli;Pei Ning;Li Yamin;Luo Ping;Gao Zhidong;Hong Feng;Wu Wenqing;Wang Jundong;Tu Dehua(Department of Out-patient , Beijing Research Institute for Tuberculosis Control,Beijing 100035 China;Departtment of Communicable Diseases , Beijing Geriatric Hospital , Beijing 100095, China;Department of Tuberculosis , Shanghai Clinical Center for Public Health , Shanghai 200003 , China;Department of Prevention and Control, Beijing Research Institute for Tuberculosis Control, Beijing 100035, China;Department of Office , Beijing Research Institute for Tuberculosis Control, Beijing 100035, China)
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2019年第3期237-241,共5页
Chinese Journal of Geriatrics
