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背景:韩国国家结核病协会胸科门诊部治疗耐多药结核病的回顾性队列分析。 目的:评估治疗结果及对其产生影响的因素。 设计:回顾性分析1988—1996年期间1011例耐多药肺结核病人根据既往治疗史及药敏试验结果而制定的个体化方案治疗的结果。 结果:病人平均年龄38.6岁。所分离的结核杆菌平均对3.7种药物耐药,平均接受既往未曾使用过的、且对其敏感的4.2种药物进行复治。治疗结果如下:治愈487例(48.2％),失败82例(8.1％),中断治疗394例(39.0％),转出45例(4.5％),死亡3例(0.3％)。在完成治疗者中,治疗有效率85.6％。多变量分析揭示,治疗有效与下列各因素显著相关:方案中含较多种未曾使用过且对其敏感的药物显著有关。(OR3.6;95％CI 1.3～9.5)、年轻(OR2.0;95％CI1.1～3.9)、耐药种类少(OR1.8;95％CI 1.1～3.1)。包括随访期的死亡率为1.7％(17例)。 结论:由于中断治愈率较高(39.0％),MDR-TB的门诊治疗的治愈率为48.2％。然而,完成治疗者的治愈率为85.6％。
Background: A retrospective cohort analysis of the treatment of multidrug-resistant tuberculosis in the chest clinic of the National Tuberculosis Association in South Korea. Purpose: To assess the outcome of treatment and the factors that affect it. Design: A retrospective analysis of the results of individualized regimens developed in 1011 MDR-TB patients from 1988 to 1996 based on past treatment history and susceptibility testing results was performed. Results: The average age of patients was 38.6 years. Mycobacterium tuberculosis isolated was resistant to an average of 3.7 drugs and received an average of 4.2 previously untreated and sensitive re-treatments. The treatment results were as follows: 487 (48.2%) were cured, 82 (8.1%) failed, 394 (39.0%) discontinued, 45 (4.5%) were withdrawn and 3 (0.3%) died. In the completion of the treatment, the treatment efficiency of 85.6%. Multivariate analysis revealed that the efficacy of treatment was significantly correlated with the following factors: The program contained a significant number of more and more drugs that were not used and were sensitive to it. (OR3.6; 95% CI 1.3 ~ 9.5), young (OR2.0; 95% CI 1.1 ~ 3.9), less resistant species (OR1.8; 95% CI 1.1 ~ 3.1). Including the follow-up of the mortality rate was 1.7% (17 cases). Conclusion: The cure rate of outpatient MDR-TB treatment was 48.2% due to the high cure rate (39.0%). However, the cure rate for those who completed the treatment was 85.6%.