Kekkaku. 2012 Feb;87(2):57-60.
The standard treatment of tuberculosis (TB) is the key to its control. Here we report the statistics of treatment history and the initial regimen for treating TB in 2009. In 2009, 24,170 TB patients were newly notified. Of those, 1751 cases were reported as having had previous treatment and 410 cases were reported as having an unknown treatment history. The proportion of patients receiving retreatment was 7.4%, excluding those of unknown treatment history. The proportion of those receiving retreatment among newly notified TB patients increased with age from those at 20-24 years old (3.2%) to those at 80-84 years old (9.3%). The frequency of retreatment among newly notified TB patients might be partly an indicator of previous insufficient treatment. Regarding the year of previous treatment, the greatest number of cases reported having received previous treatment in 2008 (n=194). The total number of cases whose previous treatment had begun in 2008 or 2009 was 224, i.e. 12.8% of all retreatment cases in 2009. On the other hand, the number of cases having received previous treatment in the 1950s was also significant (n=219, 12.5%). As the initial treatment regimen, the combination of INH (isoniazid), RFP (rifampicin), PZA (pyrazinamide)+EB (ethambutol) or SM (streptomycin) is recommended by the Japanese Society for Tuberculosis. This regimen was initially used in 80.8% of all forms of TB patients aged 15-79 years old, excluding those cases whose treatment regimen was unknown. The data on duration of having actually received PZA was added to the central TB surveillance database starting in 2007. The number of cases who started TB treatment including PZA in 2008 was 15,146. Of those, 11,997 cases had completed TB treatment by the end of 2009, but 9.9% of them could not take PZA fully for 2 months.
结核病(TB)的标准治疗是控制该病的关键。在此,我们报告2009年结核病治疗史统计数据及初始治疗方案。2009年,新报告的结核病患者有24170例。其中,1751例报告有既往治疗史,410例报告治疗史不明。排除治疗史不明的患者后,接受再治疗的患者比例为7.4%。新报告的结核病患者中接受再治疗的比例随年龄增长而增加,从20 - 24岁患者的3.2%增至80 - 84岁患者的9.3%。新报告的结核病患者再治疗频率可能部分反映了既往治疗不足。关于既往治疗年份,报告2008年接受过既往治疗的病例数最多(n = 194)。2008年或2009年开始既往治疗的病例总数为224例,即2009年所有再治疗病例的12.8%。另一方面,20世纪50年代接受过既往治疗的病例数也较多(n = 219,12.5%)。作为初始治疗方案,日本结核病协会推荐使用异烟肼(INH)、利福平(RFP)、吡嗪酰胺(PZA) + 乙胺丁醇(EB)或链霉素(SM)的联合方案。该方案最初用于15 - 79岁所有类型结核病患者的80.8%,排除治疗方案不明的病例。从2007年起,实际接受PZA治疗时长的数据被添加到中央结核病监测数据库。2008年开始包括PZA的结核病治疗的病例数为15146例。其中,11997例在2009年底完成了结核病治疗,但其中9.9%的患者无法完整服用PZA达2个月。