Nakazono T
Department of Medicine, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo.
Kekkaku. 1992 Jun;67(6):449-56.
Transient radiographic progressions during or after antituberculous chemotherapy were observed in 60 (4.5%) out of 1,321 cases with active pulmonary tuberculosis who received an initial combination chemotherapy including INH and RFP. The radiographic patterns of these progressions were classified into a singular and a gregarious pattern. A correlation between the two radiographic patterns and a positive or negative culture in sputum at the time of the radiographic progressions was studied, revealing significantly more frequent singular patterns in culture negative cases while more frequent gregarious patterns in culture positive cases. In a majority of the cases, radiographic progressions developed within 3 months after an initiation of chemotherapy. Either of the increased shadows during chemotherapy or after completion of chemotherapy showed an improvement in a moderate degree or over and a good prognosis thereafter by continuous administration of the same drugs or under observation without retreatment respectively. It is concluded that radiographic progressions appeared during an intensive chemotherapy or after its completion do not always require changing the antituberculous drugs or resumption of chemotherapy.
在1321例接受包含异烟肼（INH）和利福平（RFP）的初始联合化疗的活动性肺结核患者中，60例（4.5%）在抗结核化疗期间或之后出现了短暂的影像学进展。这些进展的影像学模式分为单发和多发模式。研究了这两种影像学模式与影像学进展时痰培养阳性或阴性之间的相关性，结果显示培养阴性病例中单发模式明显更常见，而培养阳性病例中多发模式更常见。在大多数病例中，影像学进展在化疗开始后3个月内出现。化疗期间或化疗完成后出现的阴影增加，分别通过持续使用相同药物或在无再次治疗的观察下，在中度或更严重程度上得到改善，且预后良好。结论是，在强化化疗期间或之后出现的影像学进展并不总是需要更换抗结核药物或重新开始化疗。
