Katoch K, Ramanathan U, Ramu G
Central JALMA Institute for Leprosy, Agra, India.
Int J Lepr Other Mycobact Dis. 1988 Mar;56(1):1-9.
Pyrazinamide in a dose of 1500 mg was given to 63 borderline lepromatous (BL) and lepromatous (LL) leprosy patients on different drug regimens for the initial 2 months of therapy. Fifty-one BL and LL patients were put on the same drug regimens without pyrazinamide. There was a rapid and good clinical improvement in the patients in both of the groups. At the end of 2 years, the patients who received pyrazinamide had a morphological index (MI) of zero as compared to those patients who did not receive pyrazinamide, some of whom still had solidly staining bacilli. One out of 20 (5%) scrotal (smooth muscle) biopsies of the patients who received pyrazinamide had growth in the mouse foot pad as compared to 9 out of 38 (23.7%) smooth muscle biopsies of the patients who did not receive pyrazinamide. At the end of 5 years, the patients who received pyrazinamide had slightly better results compared with the non-pyrazinamide group. Pyrazinamide appears to have some effect against persisters in multibacillary leprosy. A well-controlled, randomized trial with longer duration of pyrazinamide therapy in a larger group of patients needs to be carried out to unequivocally determine the exact role of pyrazinamide in leprosy.
在治疗的最初2个月，对63例界线类偏瘤型（BL）和瘤型（LL）麻风患者采用不同药物治疗方案，给予剂量为1500毫克的吡嗪酰胺。51例BL和LL患者采用相同药物治疗方案但未使用吡嗪酰胺。两组患者均出现快速且良好的临床改善。2年后，接受吡嗪酰胺治疗的患者形态学指数（MI）为零，而未接受吡嗪酰胺治疗的患者中，部分患者仍有大量染色阳性的杆菌。接受吡嗪酰胺治疗的患者中，20例（5%）阴囊（平滑肌）活检组织在小鼠足垫上有生长，而未接受吡嗪酰胺治疗的患者中，38例（23.7%）平滑肌活检组织有生长。5年后，接受吡嗪酰胺治疗的患者比未接受吡嗪酰胺治疗的组效果稍好。吡嗪酰胺似乎对多菌型麻风的持留菌有一定作用。需要在更大规模的患者群体中进行一项控制良好、随机的试验，延长吡嗪酰胺治疗时间，以明确确定吡嗪酰胺在麻风病中的确切作用。
