[介入治疗在多药耐药肺结核多模式治疗中的作用]

[The effect of interventional therapy in multimodality treatment on multi-drug resistant pulmonary tuberculosis].

作者信息

Fu Yu, Chu Nai-Hui, Yuan Song-Lin, Chen Wei, Wang Wei, Luo Yong-Ai, Xiao He-Ping, Zhu Li-Zhen

机构信息

Department of Tuberculosis, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing 101149, China.

出版信息

Zhonghua Jie He He Hu Xi Za Zhi. 2008 Feb;31(2):95-8.

PMID:18683778

Abstract

OBJECTIVE

To evaluate the effect of interventional therapy with antituberculous drug instillation to the lesions in the treatment of multi-drug resistant pulmonary tuberculosis (MDR-PTB) on conventional therapy.

METHODS

Sixty-one cases of MDR TB were included from January 2001 to October 2002 in five hospitals. Pasiniazide, rifapentine levofloxacin, ethambutol, ethionamide, amikacin and clarithromycin were used as the basic chemotherapy regimen. In addition, M. vaccac and interventional therapy were used, and chemotherapy was continued for a total of 18 months.

RESULTS

The sputum negative conversion rate (including sputum smear and culture) was 50.8% (31/61) after 3 months of interventional therapy. The rate increased to 83.6% (51/61) after 18 months of therapy. Chest X-ray showed that, the foci were markedly absorbed in 50.8% (31/61), and the effective rate was 93.4% (57/61) after 3 months of therapy. The foci were markedly absorbed in 78.7% (48/61) after 18 months of treatment. The effective rate was 96.7%. The rate of cavity closure was 21.3% (13/61) after 3 months of interventional therapy and it increased to 49.2% (30/61) after 18 months of treatment. The rate of symptom disappearance was 73.2%-94.4%, including fever, hemoptysis and dyspnea.

CONCLUSION

For the treatment of MDR-TB, interventional therapy is effective in improving sputum negative conversion, lesion absorption and cavity closure.

摘要

目的

评估抗结核药物介入治疗对多药耐药性肺结核（MDR-PTB）常规治疗中病灶的治疗效果。

方法

2001年1月至2002年10月，从五家医院纳入61例MDR-TB患者。使用帕司烟肼、利福喷汀、左氧氟沙星、乙胺丁醇、乙硫异烟胺、阿米卡星和克拉霉素作为基础化疗方案。此外，采用微卡和介入治疗，共持续化疗18个月。

结果

介入治疗3个月后痰菌转阴率（包括痰涂片和培养）为50.8%（31/61）。治疗18个月后该率升至83.6%（51/61）。胸部X线显示，治疗3个月后病灶明显吸收者占50.8%（31/61），有效率为93.4%（57/61）。治疗18个月后病灶明显吸收者占78.7%（48/61）。有效率为96.7%。介入治疗3个月后空洞闭合率为21.3%（13/61），治疗18个月后升至49.2%（30/61）。症状消失率为73.2%-94.4%，包括发热、咯血和呼吸困难。