论文部分内容阅读
背景:目前尚无大数量研究证明 6 个月化疗方案对各类型肺外结核病(EPTB)的疗效。方法:回顾性观察分析方法评估委内瑞拉 Caracas市 1998 年 1 月 1 日至 2000 年 12 月 31 日期间诊断的所有EPTB患者的6个月化疗方案(2HRZE/4H3R3)直接督导治疗结果。结果:共有 679 例纳入研究,其中 101 例(14.9%)合并 AIDS。83.2%患者的诊断依据是微生物学、组织学或基因扩增试验。612 例(90.1%)患者接受了 90%以上规定的治疗总剂量。有 6 例(1%)因药物不良反应而改变了治疗。在接受 90%以上规定治疗总剂量的其余 606 例中,603 例(99.5%)治愈,3 例治疗失败。在治疗结束后的2年随访中,仅有6例复发(1%)。24 例中枢神经系统结核病、27 例骨关节结核病及42 例粟粒性结核病及/或播散性结核病患者治愈后均无复发。结论:继续期周 3 次服药的 6 个月化疗方案治疗各类型肺外结核病是高效的。
Background: There are currently no large number of studies demonstrating the efficacy of 6-month chemotherapy on various types of extra-pulmonary tuberculosis (EPTB). METHODS: A retrospective observational analysis was performed to evaluate the results of a 6-month chemotherapy regimen (2HRZE / 4H3R3) in all EPTB patients diagnosed between January 1, 1998 and December 31, 2000 in Caracas, Venezuela. RESULTS: A total of 679 patients were included in the study, 101 (14.9%) with AIDS. 83.2% of patients diagnosed on the basis of microbiology, histology or gene amplification experiments. 612 (90.1%) patients received more than 90% of the prescribed total treatment dose. Six patients (1%) changed treatment due to adverse drug reactions. Of the remaining 606 patients receiving more than 90% of the prescribed total dose, 603 (99.5%) were cured and 3 failed. Of the 2-year follow-up after the end of treatment, only 6 recurred (1%). Twenty-four patients with central nervous system tuberculosis, 27 patients with osteoarthritis and 42 patients with miliary tuberculosis and / or disseminated tuberculosis had no recurrence after treatment. CONCLUSIONS: The 6-month regimen of 3 doses for the next three weeks is highly effective in treating all types of extra-pulmonary tuberculosis.