两种不同定义初治涂阳肺结核失败患者全程间歇短程化疗效果评价

目的 评价复治涂阳短程化疗方案对两种不同定义初治涂阳肺结核失败患者的复治治疗效果,为进一步提高初治失败患者的疗效提供依据.方法 观察在世行贷款结核病控制项目和广东省结核病控制项目的初治涂阳肺结核失败患者采用复治涂阳短程化疗方案治疗后,两组患者的痰菌变化和治疗效果.结果 世行贷款结控项目组初治失败患者,经复治治疗其2月末、3月末、5月末、8月末痰菌阴转率分别为66.67%、77.78%、70.37%、70.37%,治愈率为70.37%.广东省结控项目组初治失败患者经复治治疗其2月末、3月末、5月末、8月末痰菌阴转率分别为75%、85%、85%、80%,治愈率为80%.两组患者在痰菌阴转率及治愈率上均无显著性差异（P〉0.05）.两组患者其3月末痰菌阴转率与5月末、8月末比,均无明显变化.结论 初治涂阳肺结核失败患者经复治治疗,若3月末痰菌仍阳性,应根据药敏试验重新制定个体化方案治疗.

Effectiveness of Short Course Intermittent Regimen in Pulmonary Tuberculosis Patients Failed in the Initial Treatment

Objective To evaluate the effectiveness of short course intermittent regimen in pulmonary tuberculosis patients failed in the initial treatment. Methods Pulmonary tuberculosis patients failed in the initial treatment of the World Bank loaned project and Guangdong project were recruited for the study. The same re-treatment regimen was employed for the two groups of patients. The situation of sputum conversion and the outcomes of the re-treatment of tuberculosis in two groups were analyzed. Results The sputum conversion rates of patients recruited from the World Bank loaned project were 66.67% , 77.78%, 70.37%, and 70.37% after treated for 2, 3, 5, and 8 months respectively. The cure rate of the patients was 70.37%. The sputum conversion rates of the patients recruited from Guangdong project were 75%, 85%, 85% and 80% after treated for 2, 3, 5 and 8 months respectively. The cure rate of the patients was 80%. The sputum conversion rates and efficacy of re-treatment showed no statistical difference among two groups (P > 0.05). The sputum conversion rate after treated for 3 months did not significantly change with prolongs treatment. Conclusion Patients did not show sputum conversion after the re-treatment for 3 months should be treated with individual regimen designed based on the drug sensitivity test.