摘要
目的探讨采用短程化疗方案治疗首次复治肺结核的疗效、依从性及不良反应情况,为临床诊治提供依据。方法收集2018年6月至2021年3月在安徽省胸科医院就诊的符合条件的首次复治肺结核患者101例,采用随机数字表法将患者分为两组,分别为短疗程方案组(73例,采用6个月莫西沙星、利福布汀、对氨基水杨酸异烟肼、吡嗪酰胺、乙胺丁醇)和标准方案组(28例,强化期3个月使用异烟肼、利福平、吡嗪酰胺、乙胺丁醇,巩固期6个月使用异烟肼、利福平、乙胺丁醇),比较两组患者2个月痰菌阴转率、治疗转归情况、影像学病灶吸收率及不良反应发生情况。结果短疗程方案组2个月痰菌阴转率为69.0%(29/42),高于标准方案组[41.2%(7/17)],差异有统计学意义(χ^(2)=3.952,P=0.047)。短疗程方案组治疗成功率为78.1%(57/73),高于标准方案组[60.7%(17/28)],差异有统计学意义(Fisher确切概率法,P=0.039)。短疗程方案组病灶吸收情况[57例治疗成功患者中,病灶全吸4例(7.0%),显吸24例(42.1%),吸收29例(50.9%),不变0例(0.0%),恶化0例(0.0%)]明显好于标准方案组[17例治疗成功患者中,病灶全吸0例(0.0%),显吸3例(17.6%),吸收13例(76.5%),不变1例(5.9%),恶化0例(0.0%)],两组之间差异有统计学意义(Fisher确切概率法,P=0.046)。短疗程方案组不良反应发生率为11.0%(8/73),标准方案组不良反应发生率为14.3%(4/28),差异无统计学意义(χ^(2)=0.014,P=0.905)。结论在首次复治肺结核患者的治疗过程中,短疗程方案组患者相较于标准方案组患者具有更高的治疗依从性,且短疗程方案有助于痰菌阴转和病灶吸收,能够明显缩短治疗时间并提高疗效。
Objective To investigate the efficacy,compliance and adverse reactions of short-course chemotherapy in the patients with retreated pulmonary tuberculosis for the first time,and to provide evidence for clinical diagnosis and treatment. Methods A total of 101 eligible retreated tuberculosis patients admitted to Anhui Chest Hospital from June 2018 to March 2021 were enrolled and randomly divided into two groups.The shortcourse regimen group(73 cases)was given moxifloxacin,rifambutin,isoniazid aminosalicylate,pyrazinamide and ethambutol for 6 months,and the 28 patients in standard treatment group were treated with isoniazid,rifampicin,pyrazinamide and ethambutol for 3 months during the intensive phase,and isoniazid,rifampicin and ethambutol for6 months during the continuation period.The 2-month sputum conversion rate,treatment success rate,imaging focus absorption rate and adverse reactions were compared between the two groups. Results The 2 month sputum negative conversion rate(69.0%,29/42)in short-course regimen group was higher than that in standard regimen group(41.2%,7/17),the difference was statistically significant(χ^(2)=3.952,P=0.047).The treatment success rate of the short-course regimen group was 78.1%(57/73),which was higher than that of the standard regimen group(60.7%,17/28),the difference was statistically significant(Fisher’s test,P=0.039).The absorption of the lesions in the short-course regimen group was significantly better than that in the standard control group.In the short-course regimen group,there were 4 cases of total absorption(7.0%),24 cases of obvious absorption(42.1%),29 cases of absorption(50.9%),0 case of constant absorption(0.0%),and 0 case of deterioration(0.0%).In the standard treatment group,there were 0 case of total absorption(0.0%),3 cases of obvious absorption(17.6%),13 cases of absorption(76.5%),1 case of constant absorption(5.9%),and 0 case of deterioration(0.0%),and there was a significant difference between the two groups(Fisher’s test,P=0.046).The incidence of adverse r
作者
陈双双
沙巍
刘晓宁
马荣
程洁
李晔
王新强
阚晓红
CHEN Shuang-shuang;SHA Wei;LIU Xiao-ning;MA Rong;CHENG Jie;LI Ye;WANG Xin-qiang;KAN Xiao-hong(Departinent of Science and Education,Anhui Chest Hospital,Hefei 230022,China;不详)
出处
《中国防痨杂志》
CAS
CSCD
2021年第11期1153-1158,共6页
Chinese Journal of Antituberculosis
基金
“十三五”国家科技重大专项(2018ZX10722302-001-006)。
关键词
结核
肺
再治疗
临床方案
Tuberculosis
pulmonary
Retreatment
Chemotherapy regimens
