【对抗结核药物广泛耐药的结核分枝杆菌排出肺结核患者的一个过程及治疗效果】。

V Iu Mishin, O G Komissarova, V I Chukanov, A S Kononets
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引用次数: 0

摘要

本文对41例肺结核患者(男32例,女9例)进行了结核分枝杆菌(MBT)排泄检查,结果结核分枝杆菌对抗结核药物广泛耐药。在14.6%的患者中首次检测到该过程。在前一期治疗中,绝大多数患者(85.4%)接受了抗结核药物治疗。纤维海绵状结核是主要形式(73.1%)。29.3%的患者出现急性进展过程。所有(100%)患者均出现肺破坏改变和细菌排泄。所有(100%)患者均对链霉素、异烟肼、利福平和氟喹诺酮类药物耐药。值得关注的是,在该队列患者中,MBT对卡那霉素、阿米卡星、环丝氨酸等储备药物耐药率较高(58.5% ~ 73.1%)。为评价治疗效果,将所有受试者分为两组,两组临床和实验室特征相同。组1患者(n = 19)给予化疗方案2b(新发结核病例)和个体化化疗方案。第二组患者(n = 22)在治疗的基础上加用塌陷疗法。化疗3个月后,1组4例(9.8%)痰液阴性,2组6例(14.6%)痰液阴性。治疗6个月后,第1组和第2组分别有13例(31.7%)和15例(36.6%)患者的MBT排泄停止。治疗3个月、6个月后,1组2例(4.8%)、7例(17%)、2组4例(9.8%)、15例(36.6%)发生龋洞闭合(p < 0.05)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[The course of a process and the efficiency of treatment of pulmonary tuberculosis patients excreting Mycobacterium tuberculosis with extensive drug resistance to antituberculous drugs].

Forty-one pulmonary tuberculosis patients (32 males and 9 females) excreting Mycobacterium tuberculosis (MBT) with extensive drug resistance to antituberculous drugs were examined. The process was first detected in 14.6% of the patients. At the previous stage of treatment, the vast majority of patients (85.4%) received antituberculous drugs. Fibrocavernous tuberculosis was a predominant form (73.1%). The acutely progressive course of the process was observed in 29.3% of patients. Lung destructive changes and bacterial excretion were revealed in all (100%) patients. Resistance to streptomycin, isoniazid, rifampicin, and fluoroquinolones was seen in all (100%) patients. The fact that in this cohort of patients the resistance of MBT to reserve drug, such as kanamycin, amikacin, and cycloserine, is observed at a rather high rate (from 58.5 to 73.1%) is concerned about. For evaluation of the efficiency of treatment, all the examinees were divided into 2 groups, which were equal in clinical and laboratory characteristics. Group 1 patients (n = 19) were given chemotherapy regimen 2b (in new cases of tuberculosis) and individual chemotherapy regimens. Collapse therapy was additionally used in the treatment of Group 2 patients (n = 22). After 3-month chemotherapy, negative sputum was established in 4 (9.8%) and 6 (14.6%) patients in Groups 1 and 2, respectively. Following 6-month therapy, MBT excretion ceased in 13 (31.7%) and 15 (36.6%) patients in Groups 1 and 2, respectively. After 3- and 6-month therapy, decay cavity closure occurred in 2 (4.8%) and 7 (17%) Group 1 patients and in 4 (9.8%) and 15 (36.6%) Group 2 patients, respectively (p < 0.05).

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