Rikimaru T, Tanaka Y, Higuchi E, Katsuki M, Ichikawa Y, Oizumi K
First Department of Internal Medicine, Kurume University School of Medicine.
Kansenshogaku Zasshi. 1992 Feb;66(2):206-11. doi: 10.11150/kansenshogakuzasshi1970.66.206.
The clinical features of tracheobronchial tuberculosis are distinct from those of pulmonary tuberculosis in some aspects. Streptomycin (SM) is claimed by some investigators that it has a tendency to promote the development of bronchial stenosis due to scarred healing of the involved endobronchial mucosa, and, for that reason, they recommend not to use it in treatment of bronchial tuberculosis. In some patients with pulmonary tuberculosis, who have renal or hearing disturbance, SM avoided. Yet unless SM is used improvement of tuberculosis could be delayed. It is the purpose of the present investigation to point out that aerosol therapy of SM is useful for patients with respiratory tuberculosis. Furthermore, we wish to demonstrate that we can safely treat the patients with respiratory tuberculosis who suffer from renal function or hearing disorder by use of aerosol therapy of SM. Prior to clinical application of the inhalation therapy, we confirmed that the therapy was not harmful. Serum concentration of SM, when inhaled, was measured in 9 volunteers. Before and after administration of SM aerosol, spirograms were examined in 4 volunteers, nevertheless, no special abnormality was recognized. It seemed that serum concentration of SM after the administration was two low to evoke adverse reactions (less than 3.0 gamma). In 6 patients with pulmonary tuberculosis, blood gases were measured and no obvious change was observed. As a result, it was demonstrated that the endobronchial tuberculous lesions improved faster when treated by inhalation of aerosolized SM as compared with the conventional injection therapy, without evoking any apparent adverse reactions. In some of the patients with pulmonary tuberculosis, it seemed that the therapy was useful.(ABSTRACT TRUNCATED AT 250 WORDS)
气管支气管结核的临床特征在某些方面与肺结核不同。一些研究者称,链霉素(SM)有促使支气管狭窄发展的倾向,原因是受累支气管内膜黏膜瘢痕愈合,因此他们建议不将其用于支气管结核的治疗。在一些患有肺结核且有肾脏或听力障碍的患者中,不使用链霉素。然而,除非使用链霉素,否则肺结核的病情改善可能会延迟。本研究的目的是指出链霉素雾化治疗对呼吸道结核患者有用。此外,我们希望证明,通过使用链霉素雾化治疗,我们可以安全地治疗患有肾功能或听力障碍的呼吸道结核患者。在临床应用吸入疗法之前,我们证实该疗法无害。对9名志愿者测量了吸入链霉素后的血清浓度。在4名志愿者中,在给予链霉素气雾剂前后检查了肺功能图,但未发现特殊异常。给药后链霉素的血清浓度似乎过低,不会引起不良反应(低于3.0微克)。在6名肺结核患者中,测量了血气,未观察到明显变化。结果表明,与传统注射疗法相比,雾化吸入链霉素治疗时,支气管结核病变改善更快,且未引起任何明显不良反应。在一些肺结核患者中,这种疗法似乎是有效的。(摘要截选至250字)