慢性肾功能衰竭及接受替代治疗者并发结核感染的治疗

慢性肾衰及接受替代治疗者并发结核感染时，其治疗与一般抗结核治疗有所不同。应用常规剂量异烟肼时，神经毒性明显增多，且可出现精神与行为异常，加大维生素Ｂ６的剂量后可以防止。乙胺丁醇的剂量为１５ｍｇ／（ｋｇ·ｄ）时，视力障碍的发生率仍高达１７．６％。同时服用环胞素Ａ与利福平时，环胞素Ａ的剂量需增加１～４倍。异烟肼与硫唑嘌呤同时服用时，血白细胞减少的发生率增加。

Treatment of TB infection in patients with CRF and undergoing replacement therapy

When TB infection was developed in patients with CRF and undergoing replacement therapy,the treat-ment has some differences from routine anti-TB therapy. Isoniazid-induced neurotoxicity was significantlyincreased when routine dose was used. The neurologic abnormalities consisted of peripheral neuropathies aswell as central nervous system dysfunction presenting as seizures,dysarthria,euphoria and ataxia. The toxi-city may be resolved after treatment with 100mg/d pyridoxine. The incidence of ocular toxicity was 17.6%when the dose of ethambutol was 15mg/kg/d. The dose of CsA should be increased 1 4times when com-bined with rifampin. The incidence of leukopenia was increased when isoniazid and azathioprine was usedtogether.