Horo K, Koffi N B, Kouassi B A, Brou-Godé V C, Ahui B J M, Silué Y, Touré K, Gnazé Z A, Kouakou K M, N'gom A, Aka-Danguy E
Service de pneumologie, CHU de Cocody, BP 582, Abidjan cedex 03, Côte d'Ivoire.
Rev Mal Respir. 2010 Nov;27(9):1055-61. doi: 10.1016/j.rmr.2010.04.016. Epub 2010 Oct 29.
In Côte d'Ivoire, since April 2002, the antituberculous regime for category I patients (ARC-I) passed from 2RHZ/4RH to 2RHZE/4RH, without modification of the antituberculous regime for category II (ARC-II) for treatment of cases of the failures to respond to treatment with ARC-I (FARC-I) and patients with a relapse of tuberculosis (TR). The objective of this study was to determine the outcome of patients treated by ARC-II (2RHZES/1RHZE/5RHE).
This study was retrospective and compared outcomes during patient follow-up under ARC-II between 1999-2000 (period 1=267 cases) and 2004-2005 (period 2=434 cases). The ARC-II regime has been prescribed for 297 cases of FARC-I and 404 cases of TR.
The failure rate of the ARC-II regime was estimated to be 11.98% during the first period compared to 5.53% during the second (P<0.001). Among FARC-I cases, therapeutic failure was estimated to 20.54% versus 5.92% in TR group (P<0,001). We noted a positive sputum smear among FARC-I : 16.16% at the second month, 13.13% to the third month and 20.54% at the fifth month versus 4.20% at the second month, 1.48% to the third month and 5.92% at the fifth month within TB cases (P<0.001).
Management of failures to the ARC-I regime must be reviewed to prevent the development of multidrug resistant TB.
在科特迪瓦，自2002年4月起，I类患者的抗结核治疗方案（ARC-I）从2RHZ/4RH变更为2RHZE/4RH，而针对I类治疗方案无反应病例（FARC-I）和结核病复发患者（TR）的II类抗结核治疗方案（ARC-II）未作修改。本研究的目的是确定接受ARC-II（2RHZES/1RHZE/5RHE）治疗的患者的治疗结果。
本研究为回顾性研究，比较了1999 - 2000年（时期1 = 267例）和2004 - 2005年（时期2 = 434例）接受ARC-II治疗的患者随访期间的治疗结果。ARC-II方案已应用于297例FARC-I患者和404例TR患者。
ARC-II方案的失败率在第一个时期估计为11.98%，而在第二个时期为5.53%（P<0.001）。在FARC-I病例中，治疗失败率估计为20.54%，而TR组为5.92%（P<0.001）。我们注意到FARC-I患者痰液涂片阳性情况：在第二个月为16.16%，第三个月为13.13%，第五个月为20.54%；而结核病患者在第二个月为4.20%，第三个月为1.48%，第五个月为5.92%（P<0.001）。
必须重新审视ARC-I方案无反应病例的管理，以防止耐多药结核病的发生。
