石家庄市世行贷款结控项目细菌学复发随访结果

目的分析石家庄市实施世界银行贷款中国结核病控制项目远期效果,制定预防与控制措施。方法总结分析选定三县区1993、1994年项目治愈病人为对象随访复发情况。结果对589例涂阳病人进行随访,满1年时,初治病人细菌学复发率1.4%,复治病人细菌学复发率为2.9%,满2年时初治病人细菌学复发率2.5%,复治病人细菌学复发率为2.9%。结论石家庄市项目实施取得了满意的远期效果,达到了世界卫生组织的要求。     

左氧氟沙星联合卷曲霉素治疗耐多药结核疗效评价

目的　观察左氧氟沙星 (V)联合卷曲霉素 (C)方案对耐多药结核病 (MDR- TB)的疗效。方法　 132例 MDR- TB患者随机分为治疗组 6 6例和对照组 6 6例。化疗方案分别为 3VCL THZ/6 CVL,3L KZTHE/6 THL E。结果　 9个月后 ,治疗组涂阳阴转率 6 7% ,培阳阴转率 72 % ;对照组涂阳阴转率 2 7% ,培阳阴转率 33%。痰菌阴转率治疗组显著高于对照组 (P<0 .0 5 )。结论　含左氧氟沙星联合卷曲霉素治疗 MDR- TB,疗效满意。     

2010-2013年如皋市耐多药肺结核患者分析

目的通过对如皋市耐多药肺结核(MDR-TB)患者的来源及转归进行分析,探索适合该地区MDR-TB的发现策略。方法 2010-2013年收集该市所有涂阳结核病患者的痰标本,开展药敏检查,分析不同来源患者中的MDR-TB发现及转归情况。结果 4年间确诊MDR-TB患者36例,结核病患者中MDR-TB检出率为9.3%,其中86.1%的MDR-TB患者来源于MDR-TB高危人群。初治凃阳者MDR-TB检出率为1.7%,MDR-TB高危人群为34.8%,差异有统计学意义(P0.001)。MDR-TB高危人群中,慢性排菌患者MDR-TB检出率为57.1%,复发患者为34.7%,其他复治患者为22.2%,2月或3月末未发现涂片仍阳性者。纳入治疗的MDR-TB患者治疗成功率为67.7%。不同来源的MDR-TB高危人群MDR-TB检出率及治疗成功率差异均无统计学意义(P0.05)。结论该市MDR-TB疫情低于全国水平,MDR-TB高危人群是该市发现耐多药肺结核最主要人群。     

Cost effectiveness of decentralised care model for managing MDR-TB in India

Background

In India, multidrug-resistant tuberculosis (MDR-TB) patients are usually treated in hospitals. Decentralised care model, however, has been suggested as a possible alternative by the World Health Organization (WHO). In the “End TB Strategy”, the WHO highlights, as one of the key targets for 2035, that ‘no TB-affected families should face catastrophic hardship due to the tuberculosis’. Removal of financial barriers to health-care access and mitigation of catastrophic expenditures are therefore considered vital to achieve the universal health coverage (UHC) goal. Since forgoing healthcare due to the financial constraints is a known fact in India, decentralised care as an intervention choice (as against hospital-based care) might enhance equity provided it is an affordable choice. Thus, an economic evaluation was conducted, from the perspective of the national health system in India, to assess the cost-effectiveness of decentralised care compared to centralised care for MDR-TB.

Opportunities and challenges of using five-membered ring compounds as promising antitubercular agents

Tuberculosis (TB), a chronic infectious disease, is one of the greatest risks to human beings and 10 million people were diagnosed with TB and 1.6 million died from this disease in 2017. In addition, with the emergence of multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB), the TB situation has become even worse, which has aggravated the mortality and spread of this disease. To overcome this problem, research into novel antituberculosis agents with enhanced activities against MDR-TB, reduced toxicity, and shortened duration of therapy is of great importance. Fortunately, many novel potential anti-TB drug candidates with five-membered rings, which are most likely to be effective against sensitive and resistant strains, have recently entered clinical trials. Different five-membered rings such as furans, pyranoses, thiazoles, pyrazolines, imidazoles, oxazolidinone, thiazolidins, isoxazoles, triazoles, oxadiazoles, thiadiazoles, and tetrazoles have been designed, prepared, and evaluated for their antimycobacterial activity against Mycobacterium tuberculosis. In this article, we highlight the recent advances made in the discovery of novel five-membered ring compounds and focus on their antitubercular activities, toxicity, structure–activity relationships, and mechanisms of action.     

左氧氟沙星治疗耐多药肺结核近期疗效观察

目的　观察左氧氟沙星对耐多药肺结核的近期疗效。方法 92例耐多药肺结核患者随机分为治疗组 50例和对照组 42例，化疗方案分别是 3HKZThV/18HZTh，3HKZTh/18HZTh，观察两组痰菌阴转、病变吸收和症状改善情况。结果 治疗组 3月和 6月的痰菌阴转率、病变吸收率、症状改善率分别是 40.0%，58.0%；54.0%，72.0%；66.0%，76.0%，对照组分别是 19.0%，35.7%；33.3%，42.9%；38.1%，45.2%，两组之间有显著性差异 (P＜0.05)。结论 左氧氟沙星联合其他化疗药物 3月强化治疗耐多药肺结核效果明显。     

A study on pattern of resistance to second line anti tubercular drugs among multi drug resistant tuberculosis patients

Aims and objectives

To determine the prevalence and pattern of resistance to second line drugs among multi drug resistant (MDR) tuberculosis patients being treated on category IV regimen.

耐药肺结核80例治疗研究

目的观察和分析含莫西沙星方案治疗耐药肺结核的疗效。方法 2004年7月～2009年12月收治资料完整的80例耐药肺结核病例,分为治疗组40例,对照组40例。治疗组应用含莫西沙星联合抗结核化学药物,对照组应用含左氧氟沙星的抗结核化学药物。两组其他抗结核药物组成相同,疗程1年。结果两组病例疗程结束时,痰结核菌转阴率治疗组95.0%,明显高于对照组77.5%（P〈0.05）。治疗组病灶吸收和空洞闭合率分别为87.5%和60.6%;对照组病灶吸收率和空洞闭合率分别为70.0%和42.6%（P〈0.05）。结论在痰菌阴转、病灶吸收、空洞闭合方面含莫西沙星方案均明显优于含左氧氟沙星方案。