利福喷丁不同给药方法对老年肺结核患者的疗效观察

目的：改进结核病的化疗方案,使患者的耐受性增加。方法：肺结核强化期3个月,之后随机分为两组,治疗组：每周1次利福喷丁＋每周2次异烟肼;对照组每周2次利福喷丁＋每天1次异烟肼。结果：两组患者治疗结束时,痰培养、病灶吸收情况无明显差异,而空洞闭合和2 a随访复发率有明显的差异性,如除外结核空洞的病例影响,2 a随访无差异,两组患者治疗的药物不良反应有明显的统计学差异。结论：每周1次利福喷丁巩固治疗对无结核空洞的肺结核有明显的疗效,药物不良反应减少、患者耐受性增加。     

抗结核病药物

2002年国家基本药物目录列出抗结核病药物包括异烟肼、链霉素、利福平、利福喷汀、乙胺丁醇、对氨基水杨酸钠、吡嗪酰胺、丙硫异烟胺及复合剂异烟肼利福平吡嗪酰胺、异烟肼利福平和异烟肼对氨基水杨酸钠。     

利福喷丁与利福平在肺结核治疗中的药效比较及安全性探讨

目的探讨利福喷丁与利福平在治疗肺结核过程中的应用效果及安全性。方法选取2016年7月至2018年7月西安市第三医院收治的84例肺结核患者为观察对象进行回顾性分析。根据治疗方法将其分为利福喷丁组与利福平组,每组各42例。两组均采用口服吡嗪酰胺和异烟肼治疗,利福喷丁组加用口服利福喷丁治疗,利福平组加用口服利福平治疗。治疗4个月后,观察比较两组患者的临床疗效、病灶药效吸收情况以及不良反应发生率。结果两组患者在给药治疗后,临床治疗总有效率比较,利福喷丁组为92. 86%(39/42),明显高于利福平组的59. 52%(25/42),差异具有统计学意义(P 0. 05);两组患者病灶药效明显吸收率比较,利福喷丁组为66. 67%(28/42),明显高于利福平组的33. 33%(14/42),差异具有统计学意义(P 0. 05);利福喷丁组患者不良反应发生率为7. 14%(3/42),显著低于利福平组的30. 95%(13/42)差异有统计学意义(P 0. 05)。结论与利福平联合吡嗪酰胺和异烟肼治疗相比,利福喷丁联合吡嗪酰胺和异烟肼治疗肺结核,效果更明显,病灶药效吸收效果更好,临床不良反应更少,药用安全性更高,值得临床应用。     

儿童淋巴结结核的短程化学疗法

印度马德拉斯的一项对197例门诊患儿的临床试验证实:短程化学疗法可治愈儿童淋巴结结核。此197例1～12岁严重结核性淋巴结炎患儿均经活体组织检查确诊。其中168例患儿接受监督性间断药物治疗方案,即使用链霉素、利福霉素、异烟肼和吡嗪酰胺,每周3次,为时2个月;随后用链霉素和异烟肼每周2次,为时4个月。用该治疗方案有101例患儿耐受良好并能配合     

利福喷汀治疗结核病大剂量比标准剂量耐受好

利福喷汀（rifapentine）与其他抗结核病药相比具有突出的优点，即每周只需用药１次。但在利福喷汀６００mg加异烟肼９００mg每周１次治疗结核病的Ⅲ期研究中，其显著的缺点是复发率高。为进一步评估大剂量利福喷汀的安全性和耐受性，作者将１５０例人类免疫缺陷病毒阴性、结核杆菌培养阳性的病人随机分为３组，即利福喷汀６００mg组、９００mg组和１２００mg组，３组均加用异烟肼１５mg／kg，每周口服１次，共１６周。１５０例病人在分组前均已完成了标准诱导治疗。主要研究终点为因任何原因而终止治疗。结果显示，主要研究终点发生率３组…     

抗结核并高剂量左氧氟沙星治疗复治性结核性胸膜炎近期疗效及安全性评价

目的:评价抗结核并高剂量左氧氟沙星治疗复治性结核性胸膜炎的疗效及安全性.方法:选取病程在1年以上复治性结核性胸膜炎患者共60例,随机分成3组,化疗组(A组)20例,采用异烟肼(INH)、利福平(RFP)、吡嗪酰胺(PZA)、链霉素(SM)方案治疗;低剂量左氧氟沙星+化疗组(B组)20例,采用INH、RFP、PZA、SM加用左氧氟沙星注射液治疗,每天100 mL(0.3 g)静脉点滴,疗程1个月;高剂量左氧氟沙星+化疗组(C组)20例,采用INH、RFP、PZA、SM加用左氧氟沙星注射液治疗,每天100 mL(0.5 g)静脉点滴,疗程1个月.3组患者治疗后均观察胸水吸收情况及不良反应.结果:A组,显效8例(40%),好转3例(15%);B组,显效10例(50%),好转5例(25%);C组,显效15例(75%),好转4例(20%),3组疗效对比差异有显著性(P＜0.01).左氧氟沙星不良反应并不随剂量增加而增加.结论:含500 mg剂量左氧氟沙星的可乐必妥注射液每日1次给药的化疗方案治疗复治性结核性胸膜炎疗效好、副作用少,组合方案经济、合理,值得推广应用.     

耐多药肺结核病患者应用化疗方案的疗效分析

目的探讨应用化疗方案对耐多药肺结核病(MDR-TB)患者的临床疗效与转阴率。方法选取收治的100例MDR-TB患者,随机分成观察组、对照组各50例,对照组给予常规方案治疗,观察组强化期采用左氧氟沙星、丙硫异烟胺、利福喷汀、乙胺丁醇、吡嗪酰胺(5种药物)进行治疗,疗程为3个月,巩固期采用左氧氟沙星、丙硫异烟胺、利福喷汀3种药物进行治疗,疗程为15个月。治疗过程中每月进行痰结核菌检查,并定期复查胸片、肝肾功能等。结果治疗结束,观察组的病灶吸收率、空洞闭合率均显著高于对照组(P0.05);观察组患者3个月、6个月、9个月、12个月、18个月的转阴率均显著高于对照组(P0.05);两组患者在治疗期间出现轻度胃肠道反应、过敏反应、轻度肝肾损伤发生率,但差异无统计学意义(P0.05)。所有出现不良反应的患者均自愈,未合用其他药物治疗。结论观察组化疗方案对于MDR-TB具有显著的临床疗效,且不良反应相对较少。     

循证护理在缓解肺结核患者药物不良反应中的应用

目前临床常用抗结核一线药物有异烟肼、利福平、吡嗪酰胺、乙胺丁醇等,二线药物有对氨基水杨酸、利福喷汀、丙硫异烟酸等,大多有药物不良反应。循证护理又称实证护理(EBN),是护理人员在指定护理活动计划过程中,将科研与临床经验、患者需求相结合,获取实证,作为临床护理决策的依     

抗结核并高剂量左氧氟沙星治疗复治性结核性胸膜炎近期疗效及安全性评价

目的：评价抗结核并高剂量左氧氟沙星治疗复治性结核性胸膜炎的疗效及安全性。方法：选取病程在1年以上复治性结核性胸膜炎患者共60例，随机分成3组，化疗组（A组）20例，采用异烟肼（INH）、利福平（RFP）、吡嗪酰胺（PZA）、链霉素（SM）方案治疗；低剂量左氧氟沙星＋化疗组（B组）20例，采用INH、RFP、PZA、SM加用左氧氟沙星注射液治疗，每天100mL（0．3g）静脉点滴，疗程1个月；高剂量左氧氟沙星＋化疗组（C组）20例，采用INH、RFP、PZA、SM加用左氧氟沙星注射液治疗，每天100mL（0．5g）静脉点滴，疗程1个月。3组患者治疗后均观察胸水吸收情况及不良反应。结果：A组，显效8例（40％），好转3例（15％）；B组，显效10例（50％），好转5例（25％）；C组，显效15例（75％），好转4例（20％），3组疗效对比差异有显著性（P〈0．01）。左氧氟沙星不良反应并不随剂量增加而增加。结论：含500mg剂量左氧氟沙星的可乐必妥注射液每日1次给药的化疗方案治疗复治性结核性胸膜炎疗效好、副作用少，组合方案经济、合理，值得推广应用。     

利福喷丁致严重血小板减少性紫癜1例

患者 ,女 ,6 4岁 ,汉族 ,退休工人。肺结核病史 2 0余年 ,间断服用异烟肼、利福平、吡嗪酰胺 ,多次复查血常规正常 ,证明患者以往服用利福霉素类药物无血液系统不良反应。 2 0 0 2年 6月因咳嗽、咳痰、低热、盗汗、乏力 ,入我院诊断为右上浸润型肺结核 ,给予力克肺疾、利福喷丁、吡嗪酰胺抗结核治疗 ,服药 2天后出现皮肤瘀斑 ,牙龈出血 ;血常规 :白细胞 3.7×10 9/L ,红细胞 3.97× 10 12 /L ,血红蛋白 12 1g/L ,血小板 5 5×10 9/L。停用利福喷丁予地塞米松、止血药治疗 1周后血小板恢复正常 ,症状消失。继服力克肺疾、吡嗪酰胺无不良反…     

恩度联合化疗治疗非小细胞肺癌的疗效研究

目的研究重组人血管内皮抑制素(恩度)联合GP或TP方案化疗治疗晚期非小细胞肺癌(NSCLC)的疗效。方法选择62例晚期NSCLC患者,分为2组,实验组30例,予GP或TP方案化疗+恩度治疗,恩度7.5 mg/m2第1~14天连续给药,间隔7 d后重复;对照组32例,予单纯GP或TP方案治疗。所有患者至少完成2周期治疗,评判疗效及生活质量(QOL),治疗1周期后评价药物毒副反应。结果实验组有效率(43.3%)与对照组(37.5%)比较,无统计学差异;实验组疾病控制率(86.7%)明显高于对照组(62.5%);试验组中位总生存期(OS)(15个月)、中位无进展生存期(PFS)(10个月)明显长于对照组(10个月、5个月);咳嗽、疲劳积分显示实验组有缓解优势;实验组功能积分改善有优于对照组趋势,但无统计学差异;2组患者不良反应无明显差异。结论恩度联合GP或TP方案化疗治疗晚期NSCLC可提高疾病控制率、中位OS及PFS,且安全性好。     

A comparative evaluation of combined immunocorrective therapy in rheumatoid arthritis with systemic manifestations (joint Soviet-Polish research)]

Thirty-two patients with rheumatoid arthritis were included in the trial. Each of them was assigned to one of the 4 groups comparable by the main features. Each group entered 8 patients. Group 1 patients underwent hemosorption weekly for 3 weeks. After the second procedure cyclophosphamide was added at a single IV dose 1000 mg. After the third procedure the treatment was continued with methotrexate (7.5 mg, weekly). Group 2 began the treatment with methotrexate (7.5 mg, weekly). Group 3 received cyclophosphamide 200 mg IV twice a week 6 times and then 200 mg weekly orally till a total dose of 2 g. Group 4 received azathioprine in a daily dose 100 mg. The treatment with nonsteroidal antirheumatic drugs and corticosteroids was continued unchanged. After 6 months we did not see significant differences between the 4 groups.     

Prophylaxis of folate deficiency in acutely ill patients: results of a randomized clinical trial

A trial was carried out of prophylaxis of folate deficiency in 105 acutely ill patients immediately following admission to an ICU with evaluation of folate status. These patients were fed either orally or by enteral or parenteral nutrition. Three groups were established regardless of the type of nutrition: Group 1 received 5 mg/day parenteral folinic acid; Group 2 received 50 mg/week parenteral folinic acid;-Group 3 received no parenteral folinic acid. Before treatment, 19% of the patients presented very low serum folate levels (less than 2.7 ng/ml). Two of them developed acute folate deficiency with severe hematological disturbances quite reversed with folinic acid. Folate levels were inversely correlated with the severity of the clinical status and were lower in septic and feverish patients. The effect of folinic acid administration was assessed after seven days of treatment: daily administration of 5 mg folinic acid appeared to be the best regiment with normalization of serum folate levels in all cases; results appeared to be better than with 50 mg once weekly. Oral and enteral administration of folate supplies considered to be physiological (300 g/day folic acid) did not appear to be sufficient to normalize in all cases blood folate levels in these acutely ill patients.     

Effect of daily versus twice weekly long-term iron supplementation on iron absorption and status in iron-deficient women: a stable isotope study

OBJECTIVES: This work aims at studying the effect of daily versus twice weekly long-term Fe supplementation on Fe absorption and status in Fe-deficient women. DESIGN AND METHODS: The study design is a randomized controlled open study carried out in the Internal Medicine Department, CHU de Clermont-Ferrand, France. Twenty-four young women participated in this study and were randomized into two groups: Group 1 received 50 mg Fe daily, and group 2 received 50 mg Fe twice weekly for 3 months. On day 10 (D10) and on day 90 (D90) of Fe supplementation, blood samples were obtained, and women received orally about 5 mg of 57Fe, and blood was sampled at different times over 24 h. The 57Fe absorption was evaluated by calculating the areas under the curves (AUC). Fe and oxidative stress status were also assessed. RESULTS: 57Fe absorption was similar in both groups on D10 but was greatly decreased in Group 1 and remained high in Group 2 on D90. Fe status was more improved in Group 1 than in Group 2. Oxidative stress status remained statistically unchanged. CONCLUSIONS: Our study shows that daily Fe supplementation is able to correct an Fe deficiency much more than twice weekly Fe supplementation in young women.     

Effect of Saccharomyces boulardii in children with acute gastroenteritis and its relationship to the immune response

We evaluated the effect of Saccharomyces boulardii administration in otherwise healthy children aged between 6 months and 10 years who were admitted for acute diarrhoea (15 males, 12 females). The patients were randomized into two groups: group 1 (n = 16) received 250 mg S. boulardii dissolved in 5 ml of water orally twice daily for 7 days and group 2 (n = 11) received placebo. Clinical and laboratory assessments were performed on admission and on day 7 of follow-up. Both groups experienced reduced daily stool frequency, the decrease being significantly greater in group 1 on days 3 and 4 compared with group 2. Group 1 demonstrated significant increases in serum immunoglobulin A and decreases in C-reactive protein levels on day 7. The percentage of CD8 lymphocytes on day 7 was significantly higher in group 1 than group 2. This study confirmed the efficacy of S. boulardii in paediatric acute gastroenteritis and the findings suggest that S. boulardii treatment enhances the immune response.     

来氟米特治疗类风湿关节炎疗效评价

目的：通过ＩＩ期随机对照来氟米特（ＬＥＦ）和甲氨喋呤（ＭＴＸ）治疗类风湿关节炎（ＰＡ）临床疗效和安全性,旨在科学地评价ＬＥＦ在治疗ＲＡ中的作用。方法：本试验为潼单盲随机对照临床研究。５０例活动性ＲＡＵ现人随机分入ＬＥＦ组（２４例）和ＭＴＸ组（２６例）,分别服用ＬＥＦ２０ｍｇ／ｄ＋安慰剂（Ｃ）和ＭＴＸ１５ｍｇ／每周＋安慰剂（Ｂ）３个月,试验开始４周同时应用非甾体抗炎药恶丙嗪,所有病人在治疗前和试验结束后测定临床指标包括何处痛、晨僵、握力、关节压痛数／指数、关节肿胀数／指数、ＥＳＲ、ＣＲＰ、病人／医师评价等。结果：治疗１２周后,ＬＥＦ组总有效率和显效率分别为１００％和８３．３３％,ＭＴＸ组分别为９６．１５％和７３．０８％（Ｐ〈０．０５）。两组病人治疗１２周主要临床指标均较治疗前明显改善。且除晨僵外两组间改善值和改善     

Glutathione in the prevention of cisplatin induced toxicities. A prospectively randomized pilot trial in patients with head and neck cancer and non small cell lung cancer

PURPOSE: Glutathione has been shown to be an effective chemoprotector against cisplatin-induced side effects in patients with ovarian cancer. In view of this fact, we performed a randomized clinical pilot-trial in the management of other solid tumors in order to compare application of Glutathione to intensive hydration in patients undergoing chemotherapy with a regimen including cisplatin. PATIENTS AND METHODS: Twenty patients suffering from advanced non small cell lung cancer (n = 6) or head- and neck cancer (n = 14) were enrolled in the study. All patients received 80 mg/m2 cisplatin along with etoposide or 5-fluorouracil every 4 weeks. Patients randomized to application of Glutathione (n = 11) received 5 g of Glutathione immediately before application of cisplatin followed by 2000 ml of normal saline. Patients in the control group (n = 9) received 2000 ml electrolyte infusion before and 2000 ml of normal saline with forced diuresis after cisplatin. RESULTS: The intensity of hematologic toxicity was significantly less pronounced in patients treated with Glutathione than in the control group (hemoglobin: 10.7 vs 9.5 mg% respectively, p = 0.039; white blood cell count 3.3 vs 2.2 x 103/microliter respectively, p = 0.004; platelets 167 vs 95 x 103/microliter respectively, p = 0.02), whereas in terms of non-hematologic toxicity no difference was observed. Objective remission occurred in 6 out of 11 evaluable patients from the group receiving Glutathione (55%; complete remission: 9%; partial remission: 46%), and in 4 out of 8 evaluable patients from the control group (partial remission: 50%). However, there was no statistical difference in terms of response and overall survival (13.5 months vs. 10.5 months) between the two groups. CONCLUSIONS: Application of Cisplatin and Glutathione seems to be safe and feasible and the antitumoral efficacy of cisplatin is apparently not impaired by the concomitant use of Glutathione in patients with solid tumors.     

来氟米特治疗类风湿关节炎疗效评价

目的：通过Ⅱ型随机对照临床试验比较研究药物来氟米特（LEF）和阳性对照甲氨喋呤（MTX）治疗类风湿关节炎（RA）临床疗效和安全性,旨在科学地评价LEF在治疗RA中的作用。方法：本试验为单盲随机对照临床研究。50例活动性RA病人随机分入LEF组（24例）和MTX组（26例）,分别服用LEF20mg/d 安慰剂（C）和MTX15mg/每周 安慰剂（B）3个月。试验开始4周同时应用非甾体抗炎药Wu丙嗪。所有病人在治疗前和试验结束后测定临床指标包括休息痛、晨僵、据力、关节压痛数/指数、关节肿胀数/指数、ESR、CRP、病人/医师评价等。结果：治疗12周后,LEF组总有效率和显效率分别为100%和83.33%,MTX组分别为96.15%和73.08%(P＜0.05)。两组病人治疗12周主要临床指标均较治疗前明显改善,且除晨僵外两组间改善值和改善百分率比较明显差别。LEF组不良反应发生率为83%,MTX组为23.08%(P=0.012)。病人对LEF耐受性好,两组病人对药物的耐受性有明显的差异（P=0.043)。结论：LEF治疗RA病人12周,其疗效与MTX相似,未发现不良反应,病人耐受性好。     

Activity of rifapentine against Mycobacterium avium infection in beige mice.

The activity of rifapentine (MDL 473) was evaluated in the beige (C57BL/6J-bgj/bgj) mouse model of disseminated Mycobacterium avium infection. Approximately 10(7) cfu of M. avium, serotype 1, were given iv. Seven days later treatment was started with intraperitoneal rifapentine at 20 mg/kg of body weight. Treatment was given daily for five days followed by twice weekly for three weeks. The mice were killed two days after the last dose. Spleens, livers and lungs were homogenized and cfu/organ determined. Analysis of variance and Tukey honestly significant difference tests indicated that rifapentine reduced cfu in each of the organs compared with untreated controls. A dose-response experiment was performed with a daily rifapentine dose of 10, 20 or 40 mg/kg administered intraperitoneally. Dose-related reductions in cfu counts were observed in each of the organs. The activity of oral rifapentine at 20 mg/kg was demonstrated in a comparative experiment with rifampicin at 20, 40 or 60 mg/kg. Rifapentine significantly reduced cfu counts in organs compared with rifampicin. Rifapentine should be considered for further evaluation in the treatment of M. avium complex infection in humans.     

Phase I trial using weekly administration of gemcitabine and docetaxel in patients with advanced pancreatic carcinoma

BACKGROUND: In advanced pancreatic carcinoma, no effective chemotherapy has been found yet due to the lack of appropriate response. The frequent use of gemcitabine is based on the fact that there is a significant improvement in the quality of life, but neither an effect on remission nor a detectable increase in survival rates could be observed. Therefore, the hypothesis was that the combination of gemcitabine with other drugs can result in a better outcome of patients. The aim of this study was to determine the maximally tolerable dosage of gemcitabine and docetaxel using a weekly administration regimen. PATIENTS AND METHODS: Twenty-five patients with advanced or metastatic pancreatic carcinoma received combination chemotherapy using gemcitabine and docetaxel in a weekly administration regimen, beginning with 800 mg/m2 of gemcitabine and 25 mg/m2 of docetaxel. Four patients were originally enrolled for each of the seven different dosages of both drugs. Side effects were assessed according to the WHO standard. Quality of life was evaluated according to the Core Quality of Life Questionnaire (QLQ-C30) of the European Organization for Research and Treatment of Cancer. RESULTS: Using the two maximal dosages of gemcitabine and docetaxel (gemcitabine, 800 and 1,000 mg/m2, and docetaxel, 45 and 40 mg/m2; respectively), only 3 and 2 patients were enrolled, respectively, because of toxic side effects > or = grade III according to WHO grading. Maximal dosages with tolerable side effects were 1,000 mg/m2 of gemcitabine and 35 mg/m2 of docetaxel given in weekly intervals. Main side effects of this combination chemotherapy were gastrointestinal symptoms and hematologic toxicity. CONCLUSION: Combination therapy with gemcitabine and docetaxel in advanced or metastatic pancreatic carcinoma is a well-tolerated and acceptable alternative treatment option with regard to the severity of side effects and its positive impact on quality of life and tumor-associated pain. According to the study endpoint, dosages of 1,000 mg/m2 of gemcitabine and 35 mg/m2 of docetaxel are recommended as maximum-tolerated doses (given in weekly intervals) for a future phase II trial.