Sevim T, Ataç G, Güngör G, Törün I, Aksoy E, Tahaoglu K
Süreyyapasa Center for Chest Disease and Thoracic Surgery, Istanbul, Turkey.
Int J Tuberc Lung Dis. 2002 Apr;6(4):320-5.
Tuberculosis clinic in a referral hospital.
To evaluate the effect of risk factors on the outcome of retreatment in relapse and defaulter pulmonary tuberculosis patients.
A total of 57 retreatment tuberculosis patients treated and monitored in our centre between January 1997 and June 1999 were evaluated with respect to treatment outcome. Factors which have on effect on treatment outcome were investigated.
Of 57 patients, 37 (64.9%) were classified as relapse cases and 20 (35.1%) as defaulters. The treatment success rate was 71.9% (68.4% cure rate and 3.5% completion rate). Failure was encountered in 22.8%. Twenty-six patients (45.6%) exhibited resistance to at least one drug, namely rifampicin. The multidrug-resistance (MDR) rate was 18.5%. Treatment success rates were 100% and 50%, respectively, in patients in whom susceptibility to all drugs and resistance to at least one drug were detected. Successful outcome was possible in 68.8% of patients with any rifampicin resistance and in 20% of patients with MDR tuberculosis. Retreatment resulted in failure in 80% and 100%, respectively, of patients whose sputum cultures remained positive at the end of the second and third months.
Drug resistance proved the most important factor affecting treatment outcome. Success rates in retreatment of patients with any rifampicin resistance or MDR tuberculosis are low. Conversion to negative sputum results at the end of the second and third months of retreatment seems to be a significant parameter for a successful outcome.
一家转诊医院的结核病诊所。
评估危险因素对复治复发和失访肺结核患者治疗结局的影响。
对1997年1月至1999年6月在我们中心接受治疗和监测的57例复治结核病患者的治疗结局进行评估。调查影响治疗结局的因素。
57例患者中，37例（64.9%）被归类为复发病例，20例（35.1%）为失访者。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%。26例患者（45.6%）对至少一种药物即利福平耐药。耐多药率为18.5%。对所有药物敏感和对至少一种药物耐药的患者治疗成功率分别为100%和50%。任何利福平耐药患者的成功结局可能性为68.8%，耐多药结核病患者为20%。在第二个月和第三个月末痰培养仍呈阳性的患者中，复治失败率分别为80%和100%。
耐药是影响治疗结局的最重要因素。任何利福平耐药或耐多药结核病患者的复治成功率较低。复治第二个月和第三个月末痰转阴似乎是成功结局的一个重要参数。
