[老年儿童和青少年肺结核新发病例统一化疗方案的可能性评估]。

M F Gubkina, N G Ershova
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引用次数: 0

摘要

对140名13至17岁的新发活动性肺结核儿童进行了检查。临床表现以浸润性结核为主(63.6%)。病变多为弥散性(79.3%),每2例(55.1%)患者有肺组织腐烂,每3例(39.3%)患者有细菌排出。肺结核新发病例中,多药耐药比例为7.9%。治疗采用常规方案。对85例患者进行强化期(IF)治疗的疗效评估,其中18例患者接受化疗(CT) (HRZ/E/S)方案3(1组),45例患者接受CT (HRZ/E/S)方案1(2组),22例患者接受CT (HRZE[A][Fq]/[Pt])方案2B(3组)。临床实验室、x线和微生物学结果是评估IP CT疗效的标准。治疗第4个月时,所有病例均出现牙签脱落。总体而言,IF CT对老年儿童和青少年肺结核新发病例的检出率为90.6%。在弥散性进程患者中,根据肺组织损伤的程度,其范围从81.8%(组3)到91.1%(组2)不等。对于有局限性的患者,治疗效率高达100%。结核分枝杆菌(MBT)对化学药物的多重耐药,包括多重耐药(7.9%)是老年儿童和青少年肺结核新发病例IF治疗无效(9.4%)的主要原因。总体而言,肺结核新发病例和青少年常规CT方案的实际使用率为65.9%。对抗结核药物的不可控不良反应和MBT的耐药性是常规方案偏离的原因(修改,使用个别方案)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Estimation of the possibilities of using unified chemotherapy regimens in new cases of pulmonary tuberculosis in old-age children and adolescents].

A hundred and forty children aged 13 to 17 who had new-onset active pulmonary tuberculosis were examined. There was a predominance of infiltrative tuberculosis (63.6%) in the pattern of its clinical forms. The processes were more frequently disseminated (79.3%) with lung tissue decay in every two patients (55.1%) and bacterial discharge in every three patients (39.3%). Among the new cases of pulmonary tuberculosis, the proportion of its multidrug resistance was 7.9%. The routine regimens were used for treatment. The efficiency of intensive-phase (IF) treatment was evaluated in 85 patients, including 18 patients receiving chemotherapy (CT) (HRZ/E/S) regimen 3 (Group 1), 45 having CT (HRZ/E/S) regimen 1 (Group 2), and 22 having CT (HRZE[A][Fq]/[Pt]) regimen 2B (Group 3). Clinical laboratory, Xray, and microbiological findings were criteria for evaluating the efficiency of IP CT. Abacillation occurred in all cases by month 4 of therapy. By and large, the efficiency of IF CT was 90.6% in new cases of pulmonary tuberculosis among old-age children and adolescents. In patients with disseminated processes, it ranged from 81.8% (Group 3) to 91.1% (Group 2) depending on the extent of lung tissue damage. The efficiency of therapy was as high as 100% in patients with circumscribed processes. Polyresistant resistance of Mycobacterium tuberculosis (MBT) to chemical agents, including multidrug resistance (7.9%), was a main reason of ineffective IF treatment (9.4%) in new cases of pulmonary tuberculosis among old-age children and adolescents. Overall, the actual use rate of routine CT regimens was 65.9% in new cases of pulmonary tuberculosis and adolescents. Uncontrolled adverse reactions to antituberculous drugs and drug resistance in MBT were reasons for deviations of routine regimens (modifications, use of individual regimes).

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