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[淋巴结结核治疗:从推荐到实践]

[Lymph node tuberculosis treatment: from recommendations to practice].

作者信息

Lanoix J-P, Douadi Y, Borel A, Andrejak C, El Samad Y, Ducroix J-P, Schmit J-L

机构信息

Service de Pathologie Infectieuse et Tropicale, CHU d'Amiens, place Victor-Pauchet, 80000 Amiens, France.

出版信息

Med Mal Infect. 2011 Feb;41(2):87-91. doi: 10.1016/j.medmal.2010.09.007. Epub 2010 Nov 23.

Abstract

PURPOSE

Lymph node infection is the most frequent localization of extrapulmonary tuberculosis. However, there is still no consensus on the length of antimicrobial treatment.

METHODS

We conducted a retrospective study in the Department of infectious diseases and internal medicine in the Amiens Teaching Hospital, France. All patients diagnosed with lymph node tuberculosis between 1998 and 2007 were included; some patients presented with bi- or multifocal tuberculosis. The aim of the study was a practice analysis.

RESULTS

We studied 48 medical records, 16 were excluded for lack of more than 40% of data or because lymph node tuberculosis was non-active. The mean age of the 32 patients included was 49 years. The mean duration of treatment was 10.9 months (standard deviation 2.6, median 11, range 6-18). There was no statistical age difference between subgroups (lymph node tuberculosis versus multifocal tuberculosis). There was no significant difference between the 6-month treatment group and the 9-month treatment group in term of clinical response. One relapse was diagnosed, eight patients (25%) were lost to follow-up at 1 year after treatment. DISCUSSION AND REVIEW: No reliable published data was found as to the optimal duration of treatment. A high quality clinical trial should be carried out to suggest a consensus.

摘要

目的

淋巴结感染是肺外结核最常见的发病部位。然而,关于抗微生物治疗的疗程仍未达成共识。

方法

我们在法国亚眠教学医院的传染病科和内科进行了一项回顾性研究。纳入了1998年至2007年间所有诊断为淋巴结结核的患者;部分患者表现为双侧或多灶性结核。该研究的目的是进行实践分析。

结果

我们研究了48份病历,16份因数据缺失超过40%或淋巴结结核无活动性而被排除。纳入的32例患者的平均年龄为49岁。平均治疗时长为10.9个月(标准差2.6,中位数11,范围6 - 18)。各亚组(淋巴结结核与多灶性结核)之间在年龄上无统计学差异。在临床反应方面,6个月治疗组和9个月治疗组之间无显著差异。诊断出1例复发,8例患者(25%)在治疗后1年失访。讨论与综述:未找到关于最佳治疗疗程的可靠已发表数据。应开展高质量的临床试验以达成共识。

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