老年合并免疫抑制合并症肺结核患者的治疗反应和不良反应。
Treatment response and adverse reactions in older tuberculosis patients with immunocompromising comorbidities.
机构信息
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung Institute of Medical Research Center, Seoul National University College of Medicine, Seoul, Korea.
出版信息
Yonsei Med J. 2013 Sep;54(5):1227-33. doi: 10.3349/ymj.2013.54.5.1227.
PURPOSE
The aim of this study was to elucidate the effects of immunocompromising comorbidities on treatment response and adverse reactions in older tuberculosis (TB) patients.
MATERIALS AND METHODS
The medical records of 182 patients older than 65 years with proven TB by positive culture of Mycobacterium tuberculosis and with available drug susceptibility tests were reviewed retrospectively. These patients were subsequently assigned to either the comorbidity group (n=78) or non-comorbidity group (n=104) depending on whether they had immunocompromising comorbidities.
RESULTS
The mean durations of treatment were 9.9 ± 3.3 months in the comorbidity group and 9.3 ± 3.2 months in the non-comorbidity group (p=0.21). M. tuberculosis culture results converted to negative in most patients with available follow-up cultures at two months after treatment. The successful treatment rates were 94.9% and 98.9% in the comorbidity and non-comorbidity groups, respectively (p=0.30). The most common side effects of anti-TB treatment were skin rash/pruritus (13% in the comorbidity group vs. 11% in the non-comorbidity group, p=0.79), gastro-intestinal problems (14% vs. 9%, p=0.25) and hepatotoxicity (14% vs. 7%, p=0.09).
CONCLUSION
The present study shows that the successful treatment rate for TB is high and that immunocompromising comorbidities have no effect on the response to treatment and adverse effects in older TB patients.
目的
本研究旨在阐明免疫抑制合并症对老年结核病（TB）患者治疗反应和不良反应的影响。
材料和方法
回顾性分析了 182 例经结核分枝杆菌阳性培养和药敏试验证实的年龄在 65 岁以上的 TB 患者的病历，根据是否存在免疫抑制合并症，将这些患者分为合并症组（n=78）和非合并症组（n=104）。
结果
合并症组的治疗持续时间为 9.9 ± 3.3 个月，非合并症组为 9.3 ± 3.2 个月（p=0.21）。大多数有随访培养结果的患者在治疗后两个月内，结核分枝杆菌培养结果转为阴性。合并症组和非合并症组的治疗成功率分别为 94.9%和 98.9%（p=0.30）。抗结核治疗最常见的副作用是皮疹/瘙痒（合并症组 13%，非合并症组 11%，p=0.79）、胃肠问题（14% vs. 9%，p=0.25）和肝毒性（14% vs. 7%，p=0.09）。
结论
本研究表明，TB 的治疗成功率较高，免疫抑制合并症对老年 TB 患者的治疗反应和不良反应无影响。
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