耐多药肺结核对异烟肼和利福平复敏的治疗疗效分析

目的探讨复敏后的耐多药肺结核INH、RFP联合治疗的疗效。方法 50例经痰结核菌培养确定的耐多药肺结核对INH、RFP均复敏的患者随机分为两组,治疗组采用3HRZAKPT/18HRPT化疗方案治疗;对照组采用3VZPTAKCTM/18VPTCTM化疗方案治疗。比较治疗3个月、6个月、12个月、18个月、21个月的痰菌阴转率（涂片与培养）,X线胸片变化及药物不良反应。结果治疗组疗程满3个月痰菌涂片与培养阴转率（32%,28%）分别与对照组（16%,12%）无明显差异（P〉0.05）;两组满疗程痰菌涂片阴转率（48%,40%）、培养阴转率（44%,40%）,X线病灶吸收率（68%,64%）和空洞闭合率（24%,28%）均无明显差异（P〉0.05）;两组均无严重不良反应。结论 INH、RFP对复敏后的耐多药肺结核,近期临床疗效不比对照组第三线化疗方案1]的疗效差,而且治疗费用低,值得临床推广。

Analysis on multi-drug resistant tuberculosis in the treatment of recuperative sensitivity to isoniazid and rifampin

Objective To investigate the curative effect after multi-drug resistant tuberculosis in the treatment of recuperative sensitivity to isoniazid and rifampin.Methods 50 cases of TB by sputum culture identified multi-drug resistant tuberculosis to INH,RFP-min rehabilitation patients were divided into 2 groups,3HRZAKPT/18HRPT chemotherapy were used in the treatment group;3VZPTAKCTM/18VPTCTM chemotherapy were used in the control group.Sputum conversion rates（smear and culture）,X-ray changes and adverse drug reactions were contrasted in the treatment of 3 months,6 months,12 months,18 months,and 21 months.Results There was no significant difference（P〉0.05）between the treatment group and control group which the sputum smear and culture conversion rate was 32% and 28% in former and 16% and 12% in latter after 3 months;There was no significant difference between the two groups（P〉0.05）in various indices after the full course of treatment;and there were no serious side effects.Conclusion The short-term clinical efficacy on multi-drug resistant tuberculosis in the treatment of recuperative sensitivity to isoniazid and rifampin is not worse than the third-line chemotherapy and low-cost.So it is worthy to be popularized.