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背景:某一转诊医院的结核病门诊部。 目的:评估影响复发及中断过治疗的肺结核病人复治疗效的各种危险因素。 设计:评估1997.1-1999.6期间本中心治疗、督导的57例复治结核病人的疗效,并对影响疗效的因素进行了调查。 结果:57例病人中,37例(64.9％)被分类为复发病例,20例(35.1％)为中断过治疗者。治疗成功率为71.9％(治愈率68.4％完成治疗率3.5％),失败率为22.8％。至少耐利福平(RMP)一种药者26例(45.6％),耐多药率(MDR)为18.5％,对所检测药物全部敏感者及至少耐一种药物者的治疗成功率各为100％及50％。耐RMP者治疗成功者为68.8％,而MDR者则仅为20％。在复治方案治疗第二月末及三月末痰培养仍阳性者其失败率各为80％及100％。 结论:本分析证明对抗结核药物的耐药性是影响疗效最重要的因素。耐BMP或MDR的复治病人的治疗成功率低。治疗二月末及三月末痰菌阴转对治疗成功似乎也是一个重要的参数。
Background: Tuberculosis clinic in a referral hospital. PURPOSE: To assess various risk factors for the efficacy of relapse and discontinuation of tuberculosis in relapsed and untreated patients. Design: To evaluate the curative effect of 57 cases of retreatment tuberculosis treated and supervised by the center during 1997.1-1999.6, and to investigate the factors affecting curative effect. Results: Of the 57 patients, 37 (64.9%) were classified as relapsed and 20 (35.1%) were discontinued. Treatment success rate was 71.9% (cure rate 68.4% completion rate of 3.5%), the failure rate was 22.8%. At least Rifampicin (RMP) had one drug in 26 patients (45.6%) and MDR of 18.5%. The successful treatment rates for all those who were tested for the drug and for at least one drug were 100% and 50%. R.8 refractory patients were treated 68.8%, while MDR were only 20%. At the end of the second and third months of treatment, the failure rate of sputum culture was still 80% and 100% respectively. Conclusion: This analysis demonstrates that drug resistance to anti-tuberculosis drugs is the most important factor affecting efficacy. Treatment-resistant patients with BMP or MDR have a low rate of successful treatment. Treatment of sputum vaginas in late February and late March seems to be an important parameter for treatment success.