高危人群抗结核方案的探讨

目的观察高危人群适当弱化结核治疗强度对药物性肝损发生率及痰菌阴转率的影响,探讨高危人群的抗结核治疗方案。方法选取2007年6月～2008年6月收治于南京胸科医院结核科94例存在高危因素的初治菌阳病人,随机分为标化组（46例）与非标化治疗组（48例）,比较药物性肝损发生率及痰菌阴转率。结果 2个月内,非标化治疗组药物性肝损害发生率显著低于标化组（14.6%VS34.8%,P〈0.05）;2个月末,标化组与非标化治疗组：痰集菌阴转率相比差异无统计学意义（65.2%VS64.6%,P〉0.05）,痰结核菌培养阴转率相比差异无统计学意义（60.9%VS60.4%,P〉0.05）。结论对于高危因素人群应制订合理的个体化抗结核治疗方案。

Study on anti-tuberculosis therapeutic regimen in patients with high risk factors

Objective To investigate the impact on the incidence of drug-induced liver damage and sputum conversion rates of high risk group by moderate anti-tuberculosis therapy,and to discover the anti-tuberculosis therapeutic regimen for patients with high risk factors.Methods 94 cases of newly diagnosed positive acid-fast bacilli in sputum with high risk factor hospitalized in Nanjing Chest Hospital during June 2007 June 2008 were chosen,94 cases were randomized into two groups：standardized therapeutic group and moderate-standardized therapeutic group,the incidence of drug-induced liver damage and sputum conversion rates between the two groups were compared.Results Within 2 months of therapy,drug-induced liver damage rate in the moderate-standardized therapeutic group was significantly lower than that in the standardized therapeutic group（14.6% vs 34.8%,P〈0.05）;at the end of the 2 months of therapy,acid-fast bacilli conversion rates between standardized the therapeutic group and moderate-standardized therapeutic group were no statistically significance（65.2% vs 64.6%,P〉0.05）,acid-fast bacilli culture conversion rates between the standardized therapeutic group and moderate-standardized therapeutic group were no statistically significance（60.9% vs 60.4%,P〉0.05）.Conclusion Patients with high risk factors should establish a reasonable individual anti-tuberculosis therapeutic regimen.