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目的分析美沙酮替代维持治疗合并肺结核的临床疗效。方法回顾性分析2007年1月~2012年12月本中心的40例美沙酮替代治疗者合并肺结核的临床资料,比较观察组40例和对照组46例肺结核患者的临床症状、结核分布类型、痰TB检测情况及X线胸片或胸部CT的检查。结果观察组中患者病灶范围[累及2个以上肺野占有率85%(34/40)]、空洞形成率77.5%(31/40)、痰菌阳性率72.5%(29/40)、复发率62.5%(25/40);对照组病灶范围[累及2个以上肺野占有率54.3%(25/46)]、空洞形成率41.3%(19/46)、痰菌阳性率32.6%(15/46)复发率4%(2/46),两组比较差异具有统计学意义。结论美沙酮替代治疗者合并肺结核痰菌阳性率高,空洞形成率高,复发率及耐药率高。应高度重视对滥用阿片类物质合并肺结核患者的防治工作。
Objective To analyze the clinical effect of methadone maintenance therapy combined with pulmonary tuberculosis. Methods The clinical data of 40 cases of methadone replacement therapy combined with pulmonary tuberculosis in our center from January 2007 to December 2012 were analyzed retrospectively. The clinical symptoms, tuberculosis distribution type, sputum TB Detection and chest X-ray or chest CT examination. Results The extent of lesions in the observation group (85% (34/40) involving more than two lung fields), the cavity formation rate was 77.5% (31/40), the sputum positive rate was 72.5% (29/40), and the recurrence rate 62.5% (25/40) in the control group; the lesions in the control group (54.3% (25/46) involving more than two lung fields), the cavity formation rate was 41.3% (19/46), the sputum positive rate was 32.6% 46) recurrence rate of 4% (2/46), the difference between the two groups was statistically significant. Conclusion Methadone replacement therapy with tuberculosis sputum positive rate, the formation rate of high cavities, the recurrence rate and high resistance rate. Great attention should be paid to the prevention and treatment of abuse of opiates and tuberculosis patients.