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中国北京利奈唑胺治疗广泛耐药结核病的临床结局:一项基于医院的回顾性研究。

Clinical outcomes of linezolid treatment for extensively drug-resistant tuberculosis in Beijing, China: a hospital-based retrospective study.

作者信息

Liu Yu, Bao Pengtao, Wang Di, Li Yun, Tang Liping, Zhou Yi, Zhao Weiguo

机构信息

Department of Respiratory Medicine, The 309th Hospital of PLA.

出版信息

Jpn J Infect Dis. 2015;68(3):244-7. doi: 10.7883/yoken.JJID.2014.222. Epub 2015 Jan 20.

Abstract

Studies have shown that linezolid achieves good clinical outcomes against multidrug-resistant (MDR) and extensively drug-resistant (XDR) tuberculosis (TB). However, the efficacy of linezolid for individual TB patients and its precise contribution to combination regimens remain unclear for Chinese patients. This study examined the clinical outcomes and safety of linezolid in adults with XDR pulmonary TB at the Chinese PLA 309 hospital. Sixteen XDR-TB patients received linezolid (600 mg daily) in addition to vitamin B6 (50-100 mg daily) as part of their individualized treatment regimens. Of the 16 patients, 14 had received previous treatment for tuberculosis. Sputum samples for all patients showed high colony-forming unit counts when tested by a real-time polymerase chain reaction (PCR). In addition, a high proportion of patients had cavitary lesions in the lungs. Eleven of the 16 patients (68.75%) had successfully completed therapy with documented negative quantitative PCR (qPCR) data and cultures at follow-up (mean = 12 months). Three patients (18.75%) are still receiving treatment, and all 3 have shown clinical and radiographic improvement. Linezolid was discontinued for 2 patients with persistent positive qPCR data and cultures because they developed severe, intractable diarrhea and nausea shortly after beginning treatment. Data indicated that linezolid was a well-tolerated and efficient treatment for XDB-TB in of Chinese patients.

摘要

研究表明,利奈唑胺对耐多药(MDR)和广泛耐药(XDR)结核病(TB)可取得良好的临床疗效。然而,对于中国患者,利奈唑胺对个体结核病患者的疗效及其在联合治疗方案中的具体作用仍不清楚。本研究在中国人民解放军第309医院检测了利奈唑胺治疗XDR肺结核成人患者的临床疗效和安全性。16例XDR-TB患者在个体化治疗方案中除了使用维生素B6(每日50-100mg)外,还接受了利奈唑胺(每日600mg)治疗。16例患者中,14例曾接受过结核病治疗。通过实时聚合酶链反应(PCR)检测,所有患者的痰液样本显示出高菌落形成单位计数。此外,高比例患者肺部有空洞性病变。16例患者中有11例(68.75%)成功完成治疗,随访时定量PCR(qPCR)数据和培养结果记录为阴性(平均=12个月)。3例患者(18.75%)仍在接受治疗,且所有3例均显示出临床和影像学改善。2例qPCR数据和培养结果持续呈阳性的患者因在开始治疗后不久出现严重、难治性腹泻和恶心而停用利奈唑胺。数据表明,利奈唑胺是治疗中国XDB-TB患者耐受性良好且有效的药物。

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