化疗疗程对复治涂阳肺结核患者治疗效果的影响

目的探讨化疗疗程对复治涂阳肺结核患者治疗效果的影响，提高治愈水平。方法对2004—2009年确诊治疗的152例复治涂阳肺结核病人，根据痰结核菌阴转及胸片内病灶吸收情况分别给予8—24个月化疗，对痰菌阴转率及疗程结束1年后的复发率进行分析。结果强化3、4个月痰菌阴转率分别为36．84％、53．29％，优于强化2个月痰结核菌4。60％的阴转率，差异均有统计学意义（X2=24．03，P〈0．01；X2=43．79，P〈0．01）。化疗12、18个月疗程结束，停药1年随访复发率分别为22．92％、9．76％，低于化疗8个月疗程结束停药1年随访62．50％的复发率，差异均有统计学意义（x2=11．8，P〈0．01；X2=25．76，P〈0．01）。结论对于复治涂阳肺结核患者适当延长强化期和化疗疗程能够促进痰菌阴转、降低随访1年的复发率。

Impact of treatment effects of chemotherapy courses for retreated smear positive pulmonary tuberculosis

Objective To explore the treatment effects of chemotherapy courses for retreated smear positive pul- monary tuberculosis and improve the efficacy. Methods A total of 152 cases of tuberculosis patients retreated with smear positive pulmonary who hospitalized in our tuberculosis control center from 2004 to 2009 were se- lected. They were given chemotherapy courses for 8 -24 months according to sputum negative conversion and absorbing situation of chest radiograph within lesions. The negative conversion rate of sputum bacteria and one - year relapse rate of tuberculosis were analyzed. Results The sputum conversion rate of intensive treatment for 3 months and 4 months was 36. 84% and 53.29%, respectively. There was significant difference compared with 2 months, intensive treatment （4.60% , Xz =24.03, P 〈0. O1, X2 =43.79, P 〈0. O1 ） . One - year bacteriological relapse rate was 22. 92% and 9.76% at the end of treatment of 12 months and 18 months, there was significant difference compared with 8 months, 62.50% （X2 = 11.8, P 〈 0. 01 ; X2 = 25.76, P 〈 0. 01 ） . Conclusions For retreated smear positive pulmonary tuberculosis patients, prolonging properly inten- sive treatment time and chemotherapy courses of retreated smear positive pulmonary tuberculosis are helpful to increase the sputum negative conversion rate and decrease one -year bacteriological relapse rate.