Singla Neeta, Singla Rupak, Fernandes Sheron, Behera Digamber
Department of Tuberculosis and Respiratory Diseases, Lala Ram Sarup Institute of Tuberculosis and Respiratory Diseases, Sri Aurobindo, Marg, New Delhi.
Indian J Tuberc. 2009 Oct;56(4):206-12.
Sequelae of patients treated for multi-drug resistance tuberculosis (MDR-TB) remain unknown.
To assess the clinical, bacteriological, radiological and functional status of MDR-TB patients after completion of treatment.
In a cross-sectional study, MDR-TB patients who had initiated standardized, community based therapy from January 2002 to December 2006 at Lala Ram Sarup Institute of Tuberculosis and Respiratory Diseases were investigated for their current clinical, bacteriological, radiological and functional status.
Between January 2002 to December 2006, 130 patients initiated treatment, of whom 24 died. Among rest 106 patients, 63 (59%) patients could be traced: 51 were currently alive while 12 had died. The 51 alive patients had completed a mean (+/- S.D.) post treatment period of 24 +/- 14.7 months ranging from 6 to 63 months before being enrolled in the study. Among currently alive patients who could be investigated, 78% had persistent respiratory symptoms; 98% had residual radiological sequelae with 40% having far advanced involvement. Abnormal Pulmonary Function Tests were observed in 45 (96%) patients with predominantly mixed type of ventilatory abnormality in 31 (66%) patients, while 9 (19%) had pure restriction and 5 (11%) had pure obstruction. None of the patients was found to be bacteriologically positive.
Current study confirms the efficacy of the standardized regimen as none of the patients was bacteriologically positive on follow up. However, after completion of treatment significant number of cured MDR-TB patients are left with residual symptoms, abnormal X-ray chest and impairment of lung functions. These issues need to be addressed as a part of comprehensive management of MDR-TB patients under national programme.
耐多药结核病（MDR-TB）患者的后遗症仍不明确。
评估耐多药结核病患者完成治疗后的临床、细菌学、放射学和功能状况。
在一项横断面研究中，对2002年1月至2006年12月在拉拉·拉姆·萨鲁普结核病和呼吸系统疾病研究所开始接受标准化社区治疗的耐多药结核病患者的当前临床、细菌学、放射学和功能状况进行了调查。
2002年1月至2006年12月期间，130名患者开始治疗，其中24人死亡。在其余106名患者中，63名（59%）患者能够被追踪到：51人目前还活着，12人已经死亡。这51名存活患者在纳入研究前完成治疗后的平均（±标准差）时间为24±14.7个月，范围从6个月到63个月。在能够接受调查的目前存活患者中，78%有持续的呼吸道症状；98%有残留的放射学后遗症，40%有广泛进展的病变。45名（96%）患者肺功能测试异常，其中31名（66%）患者主要为混合型通气异常，9名（19%）患者为单纯限制性通气障碍，5名（11%）患者为单纯阻塞性通气障碍。没有发现患者细菌学检查呈阳性。
当前研究证实了标准化治疗方案的疗效，因为随访中没有患者细菌学检查呈阳性。然而，治疗完成后，大量治愈的耐多药结核病患者仍有残留症状、胸部X线异常和肺功能损害。作为国家计划下耐多药结核病患者综合管理的一部分，这些问题需要得到解决。
