利福喷汀治疗耐利福平肺结核的疗效分析

目的分析增加利福喷汀的用药剂量对利福平耐药肺结核的疗效,以评价利福喷汀在治疗利福平耐药患者中的作用。方法根据药敏结果选取耐利福平肺结核患者101例,分为治疗1组(利福平低耐),治疗2组(利福平高耐),两组治疗方案中均含利福喷汀,对照组(利福平高耐)治疗方案中不含利福喷汀。观察治疗后3、18个月疗效。结果治疗1组在各阶段的痰菌阴转率、病灶吸收和空洞闭和情况明显优于治疗2组和对照组,两组差异有统计学意义;治疗2组的痰菌阴转率、病灶吸收和空洞闭和情况略优于对照组,两者差异无统计学意义。结论对利福平耐药的患者尤其在利福平低度耐药病例中,可以选择增加利福喷汀用药剂量的方案进行治疗,在利福平高度耐药病例中利福喷汀的作用不能确定。

A clinical observation on treatment effect of rifapentine for rifampin resistant pulmonary tuberculosis

ObjectiveTo evaluate the role of Rifapentine for patients with Rifampin resistant pulmonary tuberculosis via observing treatment effect of Rifapentine with increased dosage for Rifampin resistant pulmonary tuberculosis. Method One hundred and one cases were enrolled according to the result of drug susceptibility.The treatment group was divided into group 1 with low concentration Rifampin resistance and group 2 with high concentration Rifampin resistance.The regimen for both group 1 and group 2 included rifapentine.The control was the high concentration Rifampin resistant group,but the regimen for this group excluded Rifapentine.The treatment effect was observed at the 3rd month and 18th month after treatment. Result Sputum negative conversion rate,focus absorption,cavity closure of group 1 were better than those of group 2 and control group.The difference was statistically significant.However,sputum negative conversion rate,focus absorption,cavity closure of group 2 were better than those of the control,but the difference was not statistically significant. Conclusions Rifapentine is a preferred drug for treatment in patients with Rifampin resistant pulmonary tuberculosis,especially for patients with low concentration Rifampin resistant pulmonary tuberculosis.However,it is controversial whether Rifapentine should be taken for patients with high concentration Rifampin resistant pulmonary tuberculosis.