摘要
目的：探讨涂阳、培阳复治肺结核对异烟肼（H）、利福平（R）低浓度耐药,耐药界（H：1μg/ml,R：50μg/ml）的患者,观察采用含静脉及局部灌注高浓度H、R联合方案的疗效。方法：将61例低度耐多药肺结核（L MDR-PTB）患者随机分成两组：实验组（A组）和对照组（B组）,均采用：2SHRZE/9HRE。A组：强化2个月,静脉输高浓度H：0.5-0.7、R：0.5-0.75,局部灌注（纤支镜病灶或空洞内介入）H：0.3-0.4、R：0.3-0.45,以期提高局部药物浓度,达到杀菌目的,巩固期继续口服高浓度H、R;B组：采用常规治疗剂量。观察痰菌阴转,病灶、空洞改变及肝功情况,统计学处理,提出治疗低度耐H、R耐多药肺结核MDR-PTB的治疗方案。结果：A组的痰涂片和培养阴转速度（逐月阴转率）治疗前和疗程结束均明显高于B组（P〈0.05）,A组大部分患者病灶趋于显著吸收和吸收,而B组患者大部分病灶改变不明显（P〈0.01）;A组空洞关闭速度及直径缩小率均较B组高（P〈0.01）。A组与B组肝损害发生率无明显变化（P〉0.05）。结论：采用含静脉及局部灌注高浓度H、R的联合方案,提高了局部药物浓度,达到杀菌目的,疗效显著优于常规剂量化疗,且未见严重的肝损害和其他副反应,收到良好效果,值得临床推广应用。
Objective： To evaluate the clinical value and safety of high concentration and large dose perfusion on treatment of multi - drug resistance pulmonary tuberculosis. Methods：sixty - one patients with low multi - drug resistant pulmonary tuberculosis cases were randomly divided into an experiment A group and control B group. The experiment group was treated by perfusion with drugs（Isoniazid 0.2, Amikacin 0.2, para- anionosalicylic acid 1.0 ＋ 0.9 % sodium chloridel0ml） and general anti - tuberculosis chemotherapy. The control group was only treated by general anti - tuberculosis chemotherapy, llesult： By the every month and the end of 6 months, the sputum tubercle bacillus conversion rate, radiagraphical improvement rate and cavity closing rate in the A groups were higher than that of the Control respectively（ P 〈 0.05, P 〈 0.01, P 〉 0.05）. Conclusion： Brochofiberscope and catheter intervention combined with chemotherapy is more effective and safe than simple chemotherapy in the treatment of MDR - TB.
出处
《内蒙古医学杂志》
2011年第11期1291-1293,共3页
Inner Mongolia Medical Journal
