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Medical plant extracts and natural compounds with a hepatoprotective effect against damage caused by antitubercular drugs: A review 被引量:4
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作者 María Adelina Jiménez-Arellanes Gabriel Alfonso Gutiérrez-Rebolledo +1 位作者 Mariana Meckes-Fischer Rosalba León-Díaz 《Asian Pacific Journal of Tropical Medicine》 SCIE CAS 2016年第12期1116-1125,共10页
Drug-induced liver injury encompasses a spectrum of diseases ranging from mild biochemical abnormalities to acute liver failure; example of this scenery is hepatotoxicity caused by the first-line antituberculous drugs... Drug-induced liver injury encompasses a spectrum of diseases ranging from mild biochemical abnormalities to acute liver failure; example of this scenery is hepatotoxicity caused by the first-line antituberculous drugs isoniazid, rifampin and pyrazinamide, which are basic for treatment of drug-sensible and drug-resistant tuberculosis. In the search for pharmacological alternatives to prevent liver damage, antitubercular drugs have been the subject of numerous studies and published reviews, a great majority of them carried out by Asian countries. At the same time, hepatoprotectors from plant source are now emerging as a possible alternative to counteract the toxic effects of these therapeutic agents. The present review aims to highlight the most recent studies on the subject, based information published in scientific databases such as Scopus and Pub Med. 展开更多
关键词 Medicinal plants Hepatoprotective effect antitubercular drugs-induced HEPATOTOXICITY Natural compounds
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Evaluation of antihepatotoxic potential of Solanum xanthocarpum fruit extract against antitubercular drugs induced hepatopathy in experimental rodents 被引量:3
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作者 Talib Hussain Ramesh K Gupta +6 位作者 Sweety K Mohd Sajid Khan Md Sarfaraj Hussain Md Arif Arshad Hussain Md Faiyazuddin Chandana Venkateswara Rao 《Asian Pacific Journal of Tropical Biomedicine》 SCIE CAS 2012年第6期454-460,共7页
Objective:To assess the hepatoprotective effect of Solanum xanthocarpum(S. xanthocarpum) fruit extract against antitubercular drug-induced liver toxicity in experimental animals.Methods:Ethanolic(50%) fruit extract of... Objective:To assess the hepatoprotective effect of Solanum xanthocarpum(S. xanthocarpum) fruit extract against antitubercular drug-induced liver toxicity in experimental animals.Methods:Ethanolic(50%) fruit extract ofS. xanthocarpum(100, 200 and 400 mg/kg bw) was administered daily for 35 days in experimental animals. Liver toxicity was induced by combination of three antitubercular drugs [isoniazid(I) 7.5 mg/kg, rifampicin(R) 10 mg/kg and pyrazinamide(P) 35 mg/kg] given orally as suspension for 35 days in rats. The hepatoprotective activity was assessed using various biochemical parameters like aspartate aminotransferase(AST), alanine aminotransferase(ALT), alkaline phosphatise(ALP), total bilirubin(TBL), albumin(ALB), total protein(TP), lactate dehydroginase(LDH), and serum cholesterol(CHL). Meanwhile,in vivoantioxidant activities as lipid peroxidation(LPO), reduced glutathione(GSH), superoxide dismutase(SOD) and catalase(CAT) were measured in rat liver homogenate. The biochemical observations were supplemented by histopathological examination.Results:The results demonstrated that treatment withS.xanthocarpumsignificantly(P<0.05-P<0.001) and dose-dependently prevented drug induced increase in serum levels of hepatic enzymes. Furthermore,S. xanthocarpumsignificantly(up toP<0.001) reduced the LPO in the liver tissue and restored activities of defence antioxidant enzymes GSH, SOD and CAT towards normal levels. Histopathology of the liver tissue showed that S. xanthocarpumattenuated the hepatocellular necrosis and led to reduction in inflammatory cells infiltration.Conclusions:The results of this study strongly indicate the protective effect of S. xanthocarpumagainst liver injury which may be attributed to its hepatoprotective activity, and thereby scientifically support its traditional use. 展开更多
关键词 SOLANUM xanthocarpum Rifampicin ISONIAZID PYRAZINAMIDE Antioxidant Antihepatotoxicity Hepatoprotective effect antitubercular drug LIVER toxicity LIVER injury Biochemical parameter Histopathology
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Hepatoprotective and in vivo antioxidant activities of the hydroethanolic leaf extract of Mucuna pruriens (Fabaceae) in antitubercular drugs and alcohol models 被引量:3
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作者 Mercy B.Obogwu Abidemi J.Akindele Olufunmilayo O.Adeyemi 《Chinese Journal of Natural Medicines》 SCIE CAS CSCD 2014年第4期273-283,共11页
AIM: Hepatotoxicity is a significantly increasing health problem worldwide, and the extent of the problem has stimulated interest in the search for hepatotherapeutic agents from plants. This study investigated the hep... AIM: Hepatotoxicity is a significantly increasing health problem worldwide, and the extent of the problem has stimulated interest in the search for hepatotherapeutic agents from plants. This study investigated the hepatoprotective and in vivo antioxidant activities of the hydroethanolic extract of Mucuna pruriens leaves in antitubercular and alcohol-induced hepatotoxicity assays in rats. METHOD: In each of the models used, seven groups were allotted. The different groups received normal saline(10 mL·kg-1, p.o.); hepatotoxicant(isoniazid-rifampicin, INH-RIF, 100 mg·kg-1, i.p. or 20% ethanol 5 g·kg-1, p.o.) and normal saline(10 mL·kg-1, p.o.); hepatotoxicant and extract at doses of 100, 200, and 400 mg·kg-1 p.o.; hepatotoxicant and silymarin 50 mg·kg-1 p.o.; and extract at 400 mg·kg-1 p.o.. On the 21st day of treatment, blood was collected for assessment of serum biochemical parameters and harvested liver samples were assessed for antioxidants. RESULTS: The hepatotoxicants significantly(P < 0.05-0.001) increased the levels of alanine transaminase(ALT), aspartate transaminase(AST), alkaline phosphatase(ALP), bilirubin, and malondialdehyde(MDA); and reduced the levels of catalase(CAT), superoxide dismutase(SOD), glutathione peroxidase(GPx), and reduced glutathione GSH compared to control. M. pruriens significantly reversed(P < 0.05-0.001) the elevation in the level of ALT, AST, ALP, and bilirubin caused by the hepatotoxicants. The extract(200 and 400 mg·kg-1) significantly reversed(P < 0.05) the diminution in the level of in vivo antioxidants and increased the level of MDA produced by INH-RIF. M. pruriens(100-400 mg·kg-1) elicited significant reduction(P < 0.001) in the level of MDA compared to the alcohol group. Silymarin also reversed the deleterious effects of the hepatotoxicants. CONCLUSION: The hydroethanolic extract of Mucuna pruriens leaves possesses hepatoprotective activity with enhancement of in vivo antioxidants as a possible mechanism of action. 展开更多
关键词 Mucuna pruriens FABACEAE HEPATOPROTECTIVE ANTIOXIDANT ALCOHOL antitubercular drugs
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Antitubercular therapy in patients with cirrhosis:Challenges and options 被引量:3
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作者 Naveen Kumar Chandan Kumar Kedarishetty +2 位作者 Sachin Kumar Vikas Khillan Shiv Kumar Sarin 《World Journal of Gastroenterology》 SCIE CAS 2014年第19期5760-5772,共13页
Tuberculosis(TB)has been a human disease for centuries.Its frequency is increased manyfold in patients with liver cirrhosis.The gold standard of TB management is a 6-mo course of isoniazid,rifampicin,pyrazinamide and ... Tuberculosis(TB)has been a human disease for centuries.Its frequency is increased manyfold in patients with liver cirrhosis.The gold standard of TB management is a 6-mo course of isoniazid,rifampicin,pyrazinamide and ethambutol.Although good results are seen with this treatment in general,the management of patients with underlying cirrhosis is a challenge.The underlying depressed immune response results in alterations in many diagnostic tests.The tests used for latent TB have many flaws in this group of patients.Three of four first-line antitubercular drugs are hepatotoxic and baseline liver function is often disrupted in patients with underlying cirrhosis.Frequency of hepatotoxicity is increased in patients with liver cirrhosis,frequently leading to severe liver failure.There are no established guidelines for the treatment of TB in relation to the severity of liver disease.There is no consensus on the frequency of liver function tests required or the cutoff used to define hepatotoxicity.No specific treatment exists for prevention or treatment of hepatotoxicity,making monitoring even more important.A high risk of multidrug-resistant TB is another major worry due to prolonged and interrupted treatment. 展开更多
关键词 antitubercular therapy Drug hepatotoxicity Multidrug-resistant tuberculosis Immune dysfunction
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Design,synthesis and in vitro evaluation of tetrahydropyrimidine-isatin hybrids as potential antitubercular and antimalarial agents 被引量:2
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作者 Tarunkumar Naniibhai Akhaia Jignesh Privakant Raval 《Chinese Chemical Letters》 SCIE CAS CSCD 2012年第7期785-788,共4页
A series of 5-substituted-3-[{5-(6-methyl-2-oxo/thioxo-4-phenyl-1,2,3,4-tetrahydropyrimidin-5-yl)-1,3,4-oxadiazol-2-yl}-imino] -1,3-dihydro-2H-indol-2-one were synthesized,characterized and screened for their anti-t... A series of 5-substituted-3-[{5-(6-methyl-2-oxo/thioxo-4-phenyl-1,2,3,4-tetrahydropyrimidin-5-yl)-1,3,4-oxadiazol-2-yl}-imino] -1,3-dihydro-2H-indol-2-one were synthesized,characterized and screened for their anti-tubercular and antimalarial activity. 展开更多
关键词 Tetrahydropyrimidines-isatin hybrid Biginelli reaction In vitro antitubercular Antimalarial activity
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Antitubercular activity of the semi-polar extractives of Uvaria rufa
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作者 Allan Patrick G Macabeo Florie A Tudla +1 位作者 Karsten Krohn Scott G Franzblau 《Asian Pacific Journal of Tropical Medicine》 SCIE CAS 2012年第10期777-780,共4页
Objective:To investigate the inhibitory activity of the chloroform extract,petroleum ether and chloroform sub-extracts,lead-acetate treated chloroform extract,fractions and secondary metabolites of Uvaria rufa(U.rufa)... Objective:To investigate the inhibitory activity of the chloroform extract,petroleum ether and chloroform sub-extracts,lead-acetate treated chloroform extract,fractions and secondary metabolites of Uvaria rufa(U.rufa) against Mycobacterium tuberculosis(M.tuberculosis) H_(37)Rv. Methods:The antituberculosis susceptibility assay was earried out using the colorimetric Microplate Alamar blue assay(MABA).In addition,the cytotoxicity of the most active fraction was evaluated using the VERO cell toxicity assay.Results:The in vitro inhibitory activity against M.tuberculosis H_(37)Rv increased as purification progressed to fractionation(MIC up to 23μg/mL). The chloroform extract and its sub-extracts showed moderate toxicity while the most active fraction from chloroform sub-extract exhibited no cytotoxicity against VERO cells.Meanwhile, the lead acetate-treated crude chloroform extract and its fractions showed complete inhibitions (100%) with MIC values up to 8μg/mL.Phylochemical screening of the most active fraction showed,in general,the presence of terpenoids,steroids and phenolic compounds.Evaluation of the antimycobacterial activity of known secondary metabolites isolated showed no promising inhibitory activity against the test organism.Conclusions:The present results demonstrate the potential of U.rufa as a phytomedicinal source of compounds that may exhibit promising antituberculosis activity.In addition,elimination of polar pigments revealed enhanced inhibition against M.tuberculosis H_(37)Rv.While several compounds known for this plant did not show antimycobacterial activity,the obtained results are considered sufficient reason for further study to isolate the metabolites from U.rufa responsible for the antitubercular activity. 展开更多
关键词 Uvaria rufa antitubercular Mycobacterium tuberculosis H_(37)Rv
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Synthesis of New Mannich Products Bearing Quinoline Nucleous Using Reusable Ionic Liquid and Antitubercular Evaluation
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作者 Hitendra M. Patel 《Green and Sustainable Chemistry》 2015年第4期137-144,共8页
A series of Mannich products bearing quinoline nucleus was synthesized, characterized, and evaluated for their in vitro antitubercular activity against Mycobacterium tuberculosis H37Rv. The results showed that compoun... A series of Mannich products bearing quinoline nucleus was synthesized, characterized, and evaluated for their in vitro antitubercular activity against Mycobacterium tuberculosis H37Rv. The results showed that compounds 4b, and 4d found most active with percentage inhibition of 95, and 96, respectively, at minimum inhibitory concentration (MIC) of >6.25 μg/mL, among the synthesized compounds. Whereas, compounds 4a, 4c, 4e, and 4f exhibited considerable antitubercular activity with percentage inhibition of 71, 79, 55, and 68, respectively, at MIC of >6.25 μg/mL. The structures of synthesized compounds were elucidated by various spectroscopic tools like IR, 1H NMR, 13C NMR, mass and elemental analysis. 展开更多
关键词 antitubercular Activity Green Synthesi MANNICH PRODUCTS MYCOBACTERIUM tuberculosis QUINOLINE Spectroscopic Tools
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Design, Synthesis and Biological Evaluation of Novel Antitubercular Agents by Combining Pyrazoline and Benzoxazole Pharmacophores
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作者 Hemal M. Soni Popatbhai K. Patel +3 位作者 Mahesh T. Chhabria Ashish K. Patel Dharmraj N. Rana Pathik S. Brahmkshatriya 《International Journal of Organic Chemistry》 CAS 2016年第3期157-176,共20页
Various recent reports on Tuberculosis have alarmed an increase in the patient class and subsequent death rates across the globe. Over and above the spread of more dangerous and fatal forms of tuberculosis like MDR-TB... Various recent reports on Tuberculosis have alarmed an increase in the patient class and subsequent death rates across the globe. Over and above the spread of more dangerous and fatal forms of tuberculosis like MDR-TB i.e. multiple-drug resistance tuberculosis, XDR-TB i.e. extensively-drug resistance tuberculosis & TDR-TB i.e. total-drug resistance tuberculosis has forwarded an urgent need to discover novel antitubercular agents. The current work is aimed at combining two previously well-known pharmacophores (pyrazoline and benzoxazole nucleus) in order to design and synthesize a series of novel benzoxazole-based pyrazoline derivatives. The synthesized target compounds were structurally confirmed by LCMS, 1H-NMR and 13C-NMR analysis. The target compounds were In vitro evaluated against M. tuberculosis H37Rv strain, multidrug-resistant TB (MDR-TB) and extensively drug-resistant TB (XDR-TB) strains. The In vitro screening results depicted that majority of the target compounds displayed potent activity with MIC in a range of ~0.8 to 6.25 μg/mL. Many compounds were found to be more potent than isoniazid against MDR-TB with MIC value 3.12 μg/mL and XDR-TB with MIC value 12.5 μg/mL. Cytotoxicity assay of these active compounds on VERO cell lines also displayed good selectivity index. 展开更多
关键词 antitubercular BENZOXAZOLE PYRAZOLINE PHARMACOPHORE Microplate Alamar Blue Assay
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Systematic Review of New Trends in Antitubercular Synthesis and Analysis
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作者 Blasie Dackouo Dominique Patomo Arama 《Journal of Materials Science and Chemical Engineering》 2019年第1期1-9,共9页
Many researches are undertaken to develop antibiotics to treat resistant tuberculosis. This review discusses new trends in research undertaken on new antituberculars reported to date, with a particular attention on th... Many researches are undertaken to develop antibiotics to treat resistant tuberculosis. This review discusses new trends in research undertaken on new antituberculars reported to date, with a particular attention on their synthesis and analysis. 展开更多
关键词 REVIEW antituberculars SYNTHESIS ANALYSIS
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Synthesis and Evaluation of 2-Amino-4H-Pyran-3-Carbonitrile Derivatives as Antitubercular Agents
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作者 Chunxia Chen Minghui Lu +4 位作者 Zhihui Liu Junting Wan Zhengchao Tu Tianyu Zhang Ming Yan 《Open Journal of Medicinal Chemistry》 2013年第4期128-135,共8页
A series of 2-amino-4H-pyran-3-carbonitrile derivatives were designed and synthesized. Their antitubercular activities were evaluated against autoluminescent M. tuberculosis H37Ra and standard strain M. tuberculosis H... A series of 2-amino-4H-pyran-3-carbonitrile derivatives were designed and synthesized. Their antitubercular activities were evaluated against autoluminescent M. tuberculosis H37Ra and standard strain M. tuberculosis H37Rv. No obvious antitubercular activities could be observed (MIC > 10 ug/mL). The results are in sharp contrast with the previously reported data. 展开更多
关键词 2-Amino-4H-Pyran-3-Carbonitrile SYNTHESIS antitubercular Activity
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Effect of antitubercular treatment on the pregnancy outcomes and prognoses of patients with genital tuberculosis 被引量:4
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作者 Jing Yue Bo Zhang +4 位作者 Mingyue Wang Junning Yao Yifan Zhou Ding Ma Lei Jin 《Frontiers of Medicine》 SCIE CAS CSCD 2019年第1期121-125,共5页
This retrospective study aims to demonstrate the effect of antitubercular treatment (ATT) on the pregnancy outcomes and prognoses of patients with genital tuberculosis (GTB) who had received laparoscopy and/ or hyster... This retrospective study aims to demonstrate the effect of antitubercular treatment (ATT) on the pregnancy outcomes and prognoses of patients with genital tuberculosis (GTB) who had received laparoscopy and/ or hysteroscopy. This study included 78 patients with infertility and who were diagnosed with GTB through laparoscopy and/or hysteroscopy over the period of November 2005 to October 2015? The recruited patients were divided into ATT and nonATT groups on the basis of ATT duration. The GTB recurrence rates, menstrual patterns, and pregnancy outcomes of the patients were determined at follow-up. Among the 78 patients, 46 received ATT and 32 did not receive ATT. The menstrual volumes of patients in the ATT group significantly decreased relative to those of patients in the nonATT group. GTB did not recur among all patients regardless of treatment. A total of 11 pregnancies (36.7%) in the ATT group and 19 pregnancies (63.3%) in the nonATT group were observed. Pregnancy rates significantly differed (P = 0.002) between the two groups.ATT may decrease the menstrual volume and pregnancy rates of patients who were diagnosed with GTB through laparoscopy and/or hysteroscopy. In addition, ATT did not improve the prognosis of patients with chronic GTB. 展开更多
关键词 antitubercular TREATMENT PREGNANCY PROGNOSIS GENITAL TUBERCULOSIS
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Synthesis and biological evaluation of new 13-n-nonylprotoberberine derivatives as antitubercular agents 被引量:4
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作者 Yinghong Li Yanxin Liu +2 位作者 Yanxiang Wang Sheng Tang Danqing Song 《Acta Pharmaceutica Sinica B》 SCIE CAS 2013年第1期38-45,共8页
Tuberculosis is a serious threat to public health throughout the world.A series of new l3-n-nonylprotoberberine derivatives was designed,synthesized and evaluated for anti-mycobacterial activity against Mycobacterium ... Tuberculosis is a serious threat to public health throughout the world.A series of new l3-n-nonylprotoberberine derivatives was designed,synthesized and evaluated for anti-mycobacterial activity against Mycobacterium tuberculosis strain H_(37)Rv.Several compounds(2,11a-c,11g,13d,15c)exhibited excellent anti-tubercular activity with an MIC below 1.0μg/mL.Notably,compound 13d showed potential antibacterial effect against both drug-susceptible and multidrug-resistant(MDR)M.tuberculosis with MIC ranges of 0.0625-1.0μg/mL.These results suggest a mode of action different from that of the current anti-mycobacterial drugs rifampicin and isoniazid.Hence,compound 13d is an attractive lead compound for the development of new antitubercular agents. 展开更多
关键词 13-n-nonylberberine antitubercular Structure-activity rela-tionship MIC DRUG-RESISTANT
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耐药肺结核患者家庭功能现状及影响因素分析 被引量:1
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作者 汤玲玲 陈丹萍 +3 位作者 李郁如 江华 黄乐 苏丽敏 《中国防痨杂志》 北大核心 2025年第8期999-1006,共8页
目的:探讨耐药肺结核患者的家庭功能现状及影响因素。方法:选取2023年10月至2024年10月同济大学附属上海市肺科医院结核科住院的300例耐药肺结核患者,对患者的一般资料进行收集,通过家庭功能评定量表(family assessment device, FAD)实... 目的:探讨耐药肺结核患者的家庭功能现状及影响因素。方法:选取2023年10月至2024年10月同济大学附属上海市肺科医院结核科住院的300例耐药肺结核患者,对患者的一般资料进行收集,通过家庭功能评定量表(family assessment device, FAD)实施家庭功能评估,并采用多因素logistic回归模型分析耐药肺结核患者家庭功能的影响因素及因素间的交互作用。结果:300例患者FAD评分总分为(136.56±10.24)分,各维度得分:沟通(20.35±2.42)分、问题解决(12.25±2.13)分、角色分工(25.47±2.50)分、行为控制(21.31±2.04)分、情感反应(14.91±2.24)分、情感介入(17.43±2.33)分、总的功能(27.62±3.11)分。多因素logistic回归分析显示,年龄≥60岁(OR=3.739,95%CI:1.331~10.510)、未婚(OR=2.362,95%CI:1.189~4.691)、PHQ-9评分≥5分(OR=2.644,95%CI:1.358~5.149)均是耐药肺结核患者家庭功能的危险因素,而文化水平为高中/中专(OR=0.113,95%CI:0.052~0.243)、文化水平为大专及以上(OR=0.060,95%CI:0.023~0.153)、医保支付(OR=0.139,95%CI:0.042~0.463)、家庭月收入>5000元(OR=0.633,95%CI:0.471~0.850)、SF-36评分≥80分(OR=0.611,95%CI:0.474~0.789)均是耐药肺结核患者家庭功能的保护因素。交互作用分析显示,年龄与文化水平[相对超危险度(RERI):95%CI为1.809~3.143,归因比(AP):95%CI为0.313~0.462,交互作用指数(S):95%CI为1.533~2.152]、年龄与家庭月收入[RERI(95%CI):0.931~1.353,AP(95%CI):0.355~0.543,S(95%CI):1.821~10.922]、年龄与PHQ-9评分[RERI(95%CI):0.053~0.268,AP(95%CI):1.058~1.762,S(95%CI):0.148~0.670]、年龄与SF-36评分[RERI(95%CI):1.063~1.804,AP(95%CI):0.152~0.721,S(95%CI):1.063~1.804]、文化水平与家庭月收入[RERI(95%CI):0.057~0.346,AP(95%CI):1.054~1.782,S(95%CI):0.160~0.765]、PHQ-9评分与SF-36评分[RERI(95%CI:0.076~0.421),AP(95%CI):1.022~1.821,S(95%CI):0.165~0.873]之间均存在相加交互作用。结论:耐药肺结核患者家庭功能处于一般水平,且受多方面因素影响,且各因素间有交互作用存在,需针对影响因素制定与实施相应的干预措施,以促进其家庭功能有效改善,进而使此病的治疗效果进一步提升。 展开更多
关键词 结核 抗药性 抗结核药 家庭关系 因素分析 统计学
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不同治疗方案的恩替卡韦联合抗结核药物治疗肺结核合并慢性乙肝的临床疗效及安全性 被引量:1
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作者 廖永美 蔡国庆 +2 位作者 李娟 代亮 刘邹 《医学临床研究》 2025年第6期923-926,共4页
【目的】探讨不同治疗方案的恩替卡韦联合抗结核药物治疗肺结核合并慢性乙型肝炎(乙肝)的临床疗效及安全性。【方法】回顾性分析2021年1月至2023年6月江西省胸科医院收治的120例初治肺结核合并慢性乙肝患者的临床资料,根据治疗方案的不... 【目的】探讨不同治疗方案的恩替卡韦联合抗结核药物治疗肺结核合并慢性乙型肝炎(乙肝)的临床疗效及安全性。【方法】回顾性分析2021年1月至2023年6月江西省胸科医院收治的120例初治肺结核合并慢性乙肝患者的临床资料,根据治疗方案的不同将患者分为对照组(n=32)、观察A组(n=47)、观察B组(n=41)。比较三组患者治疗效果和不良反应发生率,三组治疗前后血清总胆红素(TBIL)、谷丙转氨酶(ALT)、谷氨酰转肽酶(GGT)水平,三组治疗前、治疗6个月、治疗12个月、停药3个月的HBV-DNA水平。【结果】观察A组、观察B组临床总有效率高于对照组,差异有统计学意义(P<0.05)。治疗后,观察A组、观察B组血清TBIL、ALT水平高于治疗前,GGT水平低于治疗前,血清TBIL、ALT、GGT水平均低于对照组,差异有统计学意义(P<0.05)。治疗6个月、治疗12个月、停药3个月,观察A组、观察B组HBV-DNA水平均低于对照组,差异有统计学意义(P<0.05)。三组不良反应总发生率比较,差异无统计学意义(P>0.05)。【结论】肺结核合并慢性乙肝服用抗结核药物在按照“早期、规律、联合、适量和全程”的原则治疗后,继续服用抗病毒药物临床疗效会更佳,且安全性较好。 展开更多
关键词 结核 乙型肝炎 慢性 抗病毒药 抗结核药 治疗结果
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耐药肺结核患者超疗程使用德拉马尼的安全性分析
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作者 李雪莲 张红燕 +4 位作者 王隽 王庆枫 马丽萍 初乃惠 聂文娟 《中国防痨杂志》 北大核心 2025年第2期164-168,共5页
目的:探讨延长应用德拉马尼大于6个月患者的临床用药安全情况。方法:采用回顾性研究方法,搜集2022年1月至2023年12月首都医科大学附属北京胸科医院确诊为耐多药/利福平耐药肺结核,并接受含德拉马尼方案进行抗结核治疗的患者作为研究对象... 目的:探讨延长应用德拉马尼大于6个月患者的临床用药安全情况。方法:采用回顾性研究方法,搜集2022年1月至2023年12月首都医科大学附属北京胸科医院确诊为耐多药/利福平耐药肺结核,并接受含德拉马尼方案进行抗结核治疗的患者作为研究对象,共纳入49例。研究对象按照应用德拉马尼的时间分为常规组(≤6个月;29例)和延长组(>6个月;20例)。收集研究对象的流行病学史(结核病接触史等)、人口学特征(年龄、性别等)、药物不良反应信息、治疗前后心电图检查结果及临床特征(用药信息)等资料,比较常规组和延长组患者药物不良反应发生情况。结果:常规组治疗后平均QTc间期随用药时间延长而增长,至5个月时达峰值(421 ms),而后下降。延长组治疗后平均QTc间期也随用药时间延长而增长,至3个月时达峰值(450 ms),于用药8个月时再次出现较高水平(448 ms),而后下降。延长组药物不良反应的总发生率为85.0%(17/20),明显高于常规组(58.6%,17/29),差异有统计学意义(χ^(2)=3.878,P=0.049)。60.0%(12/20)的延长组患者出现QTc间期450~500 ms,明显多于常规组(27.6%,8/29),差异有统计学意义(χ^(2)=5.148,P=0.023);延长组心电图出现异常时服用德拉马尼的时间为2~9个月,平均为(3.8±0.7)个月。两组均未出现心脏不良事件,也没有患者停药。两组QTc间期≥500 ms、谷丙转氨酶/谷草转氨酶异常、胆红素异常、心肌酶异常、消化道反应、失眠等不良反应发生情况未见差异。结论:德拉马尼在用药6个月后可能具有延长疗程并保持较好安全性的可能,但需进行用药前的充分评估并在治疗过程中严密随访。 展开更多
关键词 结核 抗药性 抗结核药 治疗应用 药物评价
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干扰素γ酶联免疫斑点检测在识别抗结核药物超敏反应患者致敏药物中的价值研究
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作者 吴于青 刘㑇 廖永美 《中国全科医学》 北大核心 2025年第29期3684-3687,共4页
背景抗结核药物超敏反应在临床上常见,药物激发试验是目前唯一有效的找出致敏药物的方法,但可诱发患者再次出现过敏甚至休克,严重时危及患者生命;也有患者放弃治疗导致结核菌耐药和播散。由于目前常用的抗结核方案需要4种药物联合使用,... 背景抗结核药物超敏反应在临床上常见,药物激发试验是目前唯一有效的找出致敏药物的方法,但可诱发患者再次出现过敏甚至休克,严重时危及患者生命;也有患者放弃治疗导致结核菌耐药和播散。由于目前常用的抗结核方案需要4种药物联合使用,如何及时、精确地找出诱导患者出现超敏反应的致敏药物是临床迫切需要解决的问题。目的评估干扰素γ(IFN-γ)酶联免疫斑点法在快速识别出诱导抗结核药物治疗患者发生超敏反应的致敏药物中的临床价值。方法选取2021—2022年住院治疗的初治敏感肺结核且在治疗过程中发生药物超敏反应的患者50例,采集患者过敏急性期外周血单个核细胞,用酶联免疫斑点法检测药物特异性IFN-γ释放细胞的情况,采用药物激发试验作为判定何种药物诱导的超敏反应的金标准;分析酶联免疫斑点检测对识别抗结核四联方案(异烟肼、乙胺丁醇、利福平、吡嗪酰胺)所致超敏反应中的临床价值。结果酶联免疫斑点法在识别异烟肼、乙胺丁醇、利福平、吡嗪酰胺所致超敏反应中的灵敏度分别为69.2%(35/50)、61.5%(31/50)、75.0%(38/50)、66.7%(33/50),特异度为97.3%(49/50)、100.0%(50/50)、100.0%(50/50)、100.0%(50/50)。结论IFN-γ酶联免疫斑点检测在抗结核药物超敏反应患者急性期需进行致敏药物识别时,可作为一种体外检测的有效手段。 展开更多
关键词 结核 抗结核药 超敏反应 酶联免疫斑点法 干扰素Γ
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康替唑胺治疗结核病专家共识 被引量:3
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作者 中国防痨协会《中国防痨杂志》编辑委员会 首都医科大学附属北京胸科医院/北京市结核病胸部肿瘤研究所 +4 位作者 Inspire-CODA研究组 初乃惠 聂文娟 张文宏 孙峰 《中国防痨杂志》 北大核心 2025年第2期123-129,共7页
康替唑胺是我国自主研发的新一代噁唑烷酮类药物,已被批准用于治疗细菌引起的复杂性皮肤和软组织感染。随着康替唑胺在结核病治疗临床探索性应用的日益广泛及临床研究的不断拓展,临床医生对其临床应用的指南或规范需求愈发迫切。为此,... 康替唑胺是我国自主研发的新一代噁唑烷酮类药物,已被批准用于治疗细菌引起的复杂性皮肤和软组织感染。随着康替唑胺在结核病治疗临床探索性应用的日益广泛及临床研究的不断拓展,临床医生对其临床应用的指南或规范需求愈发迫切。为此,《中国防痨杂志》编辑委员会和中国防痨协会共同组织全国相关领域的专家进行了深入研讨,并制定了《康替唑胺治疗结核病专家共识》。本共识旨在规范和指导医务工作者在结核病治疗中使用康替唑胺,解决药物说明书或现有的抗结核治疗指南共识中缺乏关于康替唑胺抗结核治疗的适应证、剂量或疗程等问题所带来的困惑。期望本共识能为国内同行提供有益参考,共同推动康替唑胺在临床实践中的合理应用。 展开更多
关键词 恶唑烷酮类 康替唑胺 抗结核药 治疗应用 总结性报告(主题)
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耐药结核病全口服短程治疗专家共识 被引量:1
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作者 中国防痨协会 《中国防痨杂志》编辑委员会 +2 位作者 首都医科大学附属北京胸科医院/北京市结核病胸部肿瘤研究所 初乃惠 聂文娟 《中国防痨杂志》 北大核心 2025年第7期830-839,共10页
世界卫生组织发布的《耐药结核病治疗指南(2016年更新版)》中针对耐药结核病治疗推荐了全口服治疗方案。既往研究显示,使用口服短程治疗方案与含注射剂治疗方案或长程治疗方案相比,可在保证治疗成功率的基础上,获得更好的用药安全性和... 世界卫生组织发布的《耐药结核病治疗指南(2016年更新版)》中针对耐药结核病治疗推荐了全口服治疗方案。既往研究显示,使用口服短程治疗方案与含注射剂治疗方案或长程治疗方案相比,可在保证治疗成功率的基础上,获得更好的用药安全性和耐受性,以及更优的治疗依从性。世界卫生组织在《结核病整合指南模块4:耐药结核病治疗(2022年更新版)》中提出了针对耐药结核病治疗的6个月短程治疗方案(6BPaLM;其中,B:贝达喹啉,Pa:普托马尼,L:利奈唑胺,M:莫西沙星),开启了耐药结核病的全口服短程治疗时代。2024年6月世界卫生组织发布了耐药结核病新治疗方案的快速通告,新方案与世界卫生组织既往推荐的短程口服耐药方案相比更符合我国实际情况。为制定符合我国实际的全口服耐药结核病治疗方案,由中国防痨协会牵头,联合首都医科大学附属北京胸科医院/北京市结核病胸部肿瘤研究所、《中国防痨杂志》编辑委员会,组织业内专家撰写了《耐药结核病全口服短程治疗专家共识》。本共识根据近年来国内外耐药结核病全口服方案的研究进展,推荐了适宜我国国情的耐药结核病全口服短程治疗方案及适用人群,并且对全口服治疗方案使用的注意事项及不良反应处理提出了共识意见。期望通过本共识的颁布,为我国耐药结核病短程治疗方案的全面应用提供技术指引,从而进一步提高我国耐药结核病患者的治疗成功率。 展开更多
关键词 结核 抗药性 抗结核药 治疗应用 总结性报告(主题)
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抗结核药物引起的精神心理不良反应研究进展
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作者 王煜童 刘宇红 李亮 《中国防痨杂志》 北大核心 2025年第7期947-953,共7页
我国是全球结核病高负担国家之一,患者基数大。目前结核病的治疗以化疗为主,因治疗周期长且联用药物复杂,不良反应的发生不可避免。其中,精神心理不良反应较为常见,但因初期症状隐匿,缺乏特异性检测和评价指标,临床上易被忽视。本文综... 我国是全球结核病高负担国家之一,患者基数大。目前结核病的治疗以化疗为主,因治疗周期长且联用药物复杂,不良反应的发生不可避免。其中,精神心理不良反应较为常见,但因初期症状隐匿,缺乏特异性检测和评价指标,临床上易被忽视。本文综述国内外关于抗结核药物所致精神心理不良反应的发生率、危险因素、相关药物及其作用机制,以及管理策略的研究进展,旨在为此类不良反应的早期发现及干预提供理论依据和实践指导。 展开更多
关键词 抗结核药 药物毒性 精神障碍 综述文献(主题)
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45例有创机械通气重症结核病患者静脉使用 抗结核药物血药浓度分析 被引量:1
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作者 黄伟强 袁楚楚 +4 位作者 张欢 王丽丽 钟小锋 陈星星 胡明 《中国防痨杂志》 北大核心 2025年第6期798-807,共10页
选取2022年4月至2024年10月在武汉市肺科医院重症医学科行气管插管有创机械通气治疗,因胃肠功能障碍需静脉抗结核治疗并监测抗结核药物血药浓度的45例重症结核病患者作为研究对象,收集患者年龄、性别、急性胃肠功能障碍评分(AGI)、急性... 选取2022年4月至2024年10月在武汉市肺科医院重症医学科行气管插管有创机械通气治疗,因胃肠功能障碍需静脉抗结核治疗并监测抗结核药物血药浓度的45例重症结核病患者作为研究对象,收集患者年龄、性别、急性胃肠功能障碍评分(AGI)、急性生理与慢性健康评分Ⅱ(APACHEⅡ),是否合并糖尿病、感染性休克,抗结核治疗期间是否出现肝功能异常、肾功能异常,是否行连续性肾脏替代治疗(CRRT)等资料,以及常用静脉抗结核药异烟肼(INH)、利福平(RFP)、莫西沙星(Mfx)、左氧氟沙星(Lfx)、利奈唑胺(Lzd)、阿米卡星(Am)的血药浓度。结果显示,45例患者中INH、RFP、Mfx、Lfx和Lzd的血药浓度在专家共识推荐的目标范围的构成比分别为30.8%(12/39)、54.1%(20/37)、53.3%(8/15)、3/9、5/9,使用Am的3例患者,其血药浓度均未在目标范围。INH、RFP、Mfx、Lfx、Lzd和Am血药浓度与年龄、性别、是否合并糖尿病、是否合并感染性休克不相关(P值均>0.05)。在联合CRRT患者中,RFP血药浓度<8 mg/L占16.2%(6/37),8~24 mg/L占2.7%(1/37),>24 mg/L占2.7%(1/37),而未联合CRRT患者中,RFP血药浓度<8 mg/L占18.9%(7/37),8~24 mg/L占51.4%(19/37),>24 mg/L占8.1%(3/37),RFP血药浓度与联合CRRT治疗相关(χ^(2)=7.817,P=0.012)。APACHEⅡ评分高低与INH、RFP、Mfx、Lfx、Lzd和Am血药浓度无相关性(P>0.05),血药浓度水平与是否出现肝功能异常、肾功能异常亦无相关性(P>0.05)。可见,重症结核病患者病情复杂,在使用常用抗结核药物后,血药浓度未能达到专家共识推荐的目标范围的情况较为普遍,联合CRRT治疗对RFP血药浓度有一定的影响,临床上需严密监测。 展开更多
关键词 结核 抗结核药 药物监测 重症监护 通气机 机械
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