利福平不同给药途径对老年肺结核患者治疗依从性和疗效的影响

目的 比较初治菌阳老年肺结核患者使用标准化疗方案时,静脉与口服两种不同方法应用利福平的疗效和依从性.方法 将100例初治菌阳老年肺结核患者,随机分为治疗组、对照组,强化期分别用HEZ加利福平注射液和HEZ加利福平胶囊方案治疗.分另观察消化道反应、肝功能异常率、结核症状好转率、痰菌阴转率、X线胸片吸收率.结果 治疗组与对照组3 d内消化道反应率分别为14%和82%（P＜0.05）;1周末肝功能异常率分别为16%和12%（P＞0.05）;2周末肝功能异常率分别为36%和30%（P＞0.05）;1周内结核症状好转率分别为96%和70%（P＜0.05;2周末胸片显吸率分别为80%和32%（P＜0.05）;2月末痰涂片阴转率分别为52%和34%（P＞0.05）;6月末痰涂片阴转率分别为96%和82%（P＜0.05）;疗程内方案更改率分别为14%和82%（P＜0.05）.结论 初治老年肺结核患者强化期静脉较口服应用利福平疗效指标优化,消化道反应减少,肝功能异常发生率无明显增加,标准方案治疗依从性显著提高.

Comparison of the effect and compliance of Rifampicin by different administration in treating pulmonary tuberculosis in elderly patients

Objective To compare the effect and compliance of Rifampicin by vein and oral in treating pulmonary tuberculosis in elderly patients who were primary treated and had positive sputum. Methods A total of 100 first-time smear-positive pulmonary tuberculosis patients were randomly divided into two groups, the treatment group and the control group,with 50 cases in each group. During the observation enhancement period,patients of the treatment group were given HZE added rifampin inoculation fluid and HEZ plus rifampin capsules for the control group.The indicators were recorded, such as:the rate of digestive discomfort, liver digfunction ,symptom improvement, sputum smear negative conversion at the end of the second month and chest X-ray improvement. Results In therapy group and control group,the rate of digestive discomfort was 14% and 82% respectively,P ＜0. 05 ;the rate of liver disfunction at the first weekend was 16% and 12% respectively(P ＞ 0. 05 ) ;The rate of liver disfunction at the second weekend was 36% and 30% respectively(P ＞0. 05) ;The rate of the symptom improvement was 96% and 70% respectively ( P ＜ 0. 05 ) ;The rate of improvement remarkably in chest film was 80% and 32% respectively( P ＜ 0. 05 ) ;The rate of sputum smear negative conversion at the end of the second month was 52% and 34% ,P ＞0. 05 ;the rate of.sputum smear negative conversion at the end of the sixth month was 96% and 82% (P ＜ 0. 05 ) ;The rate of chemotherapy formula changed during the therapy was 14% and 82% ( P ＜ 0. 05). Conclusion The Rifampicin was used by vein in elderly PTB that primary treated and got positive sputum could get better effect indexes,less side effect in digestive tract,similar liver disfunction and fine compliance to the standardized chemotherapy formula.