抗结核药物导致伪膜性肠炎一例并文献复习

目的 探讨抗结核药物引起伪膜性肠炎的机制、临床特征,为临床诊疗提供参考.方法 报道并分析菏泽市立医院收治的1例伪膜性肠炎患者的临床资料,并收集1990年1月至2020年5月国内外报道的抗结核药物导致伪膜性肠炎的文献,分析导致伪膜性肠炎的药物及疾病临床特点、预后情况并进行总结.结果 联同本例共复习抗结核药物导致伪膜性肠炎...

Pseudomembranous colitis caused by antitubercular agents:a case report and review of literature

Objective To investigate the mechanism and clinical features of pseudomembranous colitis(PMC)caused by antitubercular agents for providing a reference for its clinial treatment.Methods One PMC case was admitted to our hospital in January 2019,and the remaining 27 cases were reported at home and abroad from January 1990 to May 2020 after the application of anti-tuberculosis drugs,all of which were obtained by literature retrieval.The domestic and foreign literature on PMC caused by antitubercular agents were reviewed.The agents causing PMC,clinical characteristics and prognosis were analyzed and summarized.Results In this paper,28 PMC cases caused by anti-tuberculosis drugs were reviewed.The ratio of men to women was 1.0∶1.5,with a median age of 65.5 years.The 22 cases were aged 60 years and over,accounting for 78.6 percent.The onset time of PMC symptoms in 28 patients was from 6 d to 126 d after anti-tuberculosis treatment,with a median time of 32 d.All patients immediately after diagnosis of PMC stopped all anti-tuberculosis drugs,and received metronidazole or vancomycin,with a good prognosis.Seven cases relapsed after continuing anti-tuberculosis treatment.Of them,4 cases had no recurrence only after stopping or replacing rifampicin with other drugs.Conclusions The incidence of PMC is increased in elderly patients with long-term use of rifampicin anti-tuberculosis treatment,and it is easy to relapse.The prolonged use of rifampicin should be avoided or replaced with other anti-tubercular agents.