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[合并精神分裂症的新发肺结核患者:治疗过程及疗效]

[New-onset pulmonary tuberculosis patients with schizophrenia: course and efficiency of treatment].

作者信息

Mishin V Iu, Shevchuk E Iu, Tsygankov B D, Losev L V

出版信息

Probl Tuberk Bolezn Legk. 2008(6):6-10.

Abstract

To investigate the specific features of the course and efficiency of treatment, the authors examined 72 patients with new-onset pulmonary tuberculosis and schizophrenia versus 68 new-onset pulmonary tuberculosis patients without mental diseases. Tuberculosis has been found to be identified in 66.7% of schizophrenics by lung fluorography made at a mental hospital or specialized dispensary. This mainly diagnoses the circumscribed forms of the disease with a low bacterial discharge, drug resistance, and cavitation while in nonschizophrenics, pulmonary tuberculosis is detected in 33.3% of cases in general health care network facilities. Following 9 months, complex treatment of pulmonary tuberculosis in schizophrenics succeeded in ceasing bacterial discharge, as shown by microscopy and sputum cultures, in 94.4 and 84.5% of cases, respectively. However, in schizophrenics receiving chemotherapy for tuberculosis, adverse reactions are revealed in 63.9% of cases, with this the incidence of these reactions depends not only on antituberculosis drugs, but also on drugs taken by patients for schizophrenia. Schizophrenic patients with pulmonary tuberculosis need an individual approach to treating the patient, longer treatment, intermittent use of antituberculosis agents, regular clinical and laboratory monitoring of the development of side effects, and complex pathogenetic treatment.

摘要

为了研究病程特点及治疗效果,作者对72例新发肺结核合并精神分裂症患者与68例无精神疾病的新发肺结核患者进行了检查。在精神病院或专科门诊进行的肺部透视检查发现,66.7%的精神分裂症患者患有肺结核。这主要诊断出疾病的局限性形式,细菌排出量低、耐药性及空洞形成情况较少,而在非精神分裂症患者中,普通医疗保健网络机构中肺结核的检出率为33.3%。9个月后,对精神分裂症患者的肺结核进行综合治疗,显微镜检查和痰培养结果显示,分别有94.4%和84.5%的病例成功停止细菌排出。然而,在接受抗结核化疗的精神分裂症患者中,63.9%的病例出现不良反应,这些反应的发生率不仅取决于抗结核药物,还取决于患者治疗精神分裂症所服用的药物。患有肺结核的精神分裂症患者需要采取个体化的治疗方法,延长治疗时间,间歇使用抗结核药物,定期对副作用的发生情况进行临床和实验室监测,并进行综合病因治疗。

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