Yoshiyama Takashi, Ogata Hideo, Ito Kunihiko, Aono Akio, Wada Masako
Fukujuji Hospital, Japan Anti-Tuberculosis Association, Kiyose-shi, Tokyo, Japan.
Kekkaku. 2007 Feb;82(2):95-101.
To evaluate treatment results of Rifampicin (R) resistant Isoniazid (H) susceptible tuberculosis cases.
Cohort analysis of twenty-three H susceptible R resistant tuberculosis cases started treatment in 1985-2004 at Fukujuji Hospital, by the retrospective review.
Three cases became Multi-drug resistant tuberculosis (MDR TB), seventeen cases were cured, two cases died, and one case transferred out. One started treatment with HR became MDR, one of the two started treatment with HR+ Ethambutol (E) became MDR and one of them was cured, eight among ten cases started treatment with HR+Pyrazinamide + (E or Streptomycine (S)) were cured, one among the ten died and one among the ten transferred out, one started treatment with RZE was cured, three among the five cases started treatment with three effective drugs without Z were cured, one among the five died, one among the five became MDR. Three cases started treatment with four effective drugs were cured. Among the nineteen cases continued treatment for more than six months, ten cases treated with four or five effective drugs for at least two months were cured, two cases of nine cases treated with three drugs or less became MDR, seven of the nine cases were cured. Among the same nineteen cases, eleven cases not treated with two or less effective drugs were cured, one case treated with two or less effective drugs for six months became MDR and one of them treated with one or two effective drug for one to three months became MDR and some were cured. The used drugs were H, E, Pyrazinamide, Streptomycin, Kanamycin, Ethionamide and New Quinolones. The duration of treatment of cured cases were eleven to twelve months in 3 cases, twelve to eighteen months in 3 cases, eighteen to twenty-four months in 8 cases and more than two years in 3 cases.
If the starting regimen is HRZE, we can cure R resistant H susceptible tuberculosis by the use of four effective drugs for more than two months and at least three effective drugs with the total duration of treatment for twelve to twenty-four months.
评估对利福平（R）耐药但对异烟肼（H）敏感的结核病病例的治疗效果。
通过回顾性分析，对1985年至2004年在福住寺医院开始治疗的23例对H敏感但对R耐药的结核病病例进行队列分析。
3例变为耐多药结核病（MDR-TB），17例治愈，2例死亡，1例转出。1例开始用HR治疗后变为MDR，2例中1例开始用HR + 乙胺丁醇（E）治疗后变为MDR且其中1例治愈，10例中8例开始用HR + 吡嗪酰胺 +（E或链霉素（S））治疗后治愈，10例中1例死亡，10例中1例转出，1例开始用RZE治疗后治愈，5例中3例开始用三种不含Z的有效药物治疗后治愈，5例中1例死亡，5例中1例变为MDR。3例开始用四种有效药物治疗后治愈。在持续治疗超过6个月的19例中，10例用四种或五种有效药物治疗至少2个月后治愈，9例中2例用三种或更少药物治疗后变为MDR，9例中7例治愈。在同一19例中，11例未用两种或更少有效药物治疗后治愈，9例中1例用两种或更少有效药物治疗6个月后变为MDR，9例中1例用一种或两种有效药物治疗1至3个月后变为MDR且部分治愈。使用的药物有H、E、吡嗪酰胺、链霉素、卡那霉素、乙硫异烟胺和新型喹诺酮类。治愈病例的治疗时间为3例11至12个月，3例12至18个月，8例18至24个月，3例超过2年。
如果初始治疗方案为HRZE，通过使用四种有效药物治疗超过2个月且至少三种有效药物，总治疗时间为12至24个月，可治愈对R耐药但对H敏感的结核病。
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