Kavesh N G, Holzman R S, Seidlin M
Department of Medicine, New York University School of Medicine, NY 10016.
Am Rev Respir Dis. 1989 May;139(5):1094-7. doi: 10.1164/ajrccm/139.5.1094.
Eight patients being treated for tuberculosis prior to starting azidothymidine therapy (study group) were compared with 56 patients who were treated with azidothymidine but not with antimycobacterial agents (control group). Toxicity was assessed 12 wk after the initiation of treatment with azidothymidine. Study group patients were more likely than control subjects to be either black or Hispanic (75% versus 30%, p = 0.02). There were no other statistically significant demographic differences. Seven study patients, and 20 control subjects experienced a fall in leukocyte count greater than 10% (88% versus 36%, p = 0.01). Within each group, patients with acquired immune deficiency syndrome (AIDS) were more likely to experience this degree of hematologic toxicity than were patients with AIDS-related complex (p = 0.03). However, analysis of covariance showed no significant differences between the groups after 12 wk of azidothymidine with regard to mean leukocyte or platelet counts, hemoglobin levels, or values for tests of liver function. The groups were similar in transfusion requirements and frequency of changes in azidothymidine dosage. Although this study was limited in power by the number of patients and the nonrandomized, retrospective design, the data suggest that patients can tolerate concurrent therapy with azidothymidine and antimycobacterial agents without unacceptable toxicity.
将8名在开始齐多夫定治疗前正在接受结核病治疗的患者(研究组)与56名接受齐多夫定治疗但未接受抗分枝杆菌药物治疗的患者(对照组)进行了比较。在开始使用齐多夫定治疗12周后评估毒性。研究组患者比对照组患者更有可能是黑人或西班牙裔(75%对30%,p = 0.02)。在人口统计学方面没有其他具有统计学意义的差异。7名研究组患者和20名对照组患者的白细胞计数下降超过10%(88%对36%,p = 0.01)。在每组中,获得性免疫缺陷综合征(AIDS)患者比艾滋病相关综合征患者更有可能出现这种程度的血液学毒性(p = 0.03)。然而,协方差分析显示,在使用齐多夫定12周后,两组在平均白细胞或血小板计数、血红蛋白水平或肝功能测试值方面没有显著差异。两组在输血需求和齐多夫定剂量变化频率方面相似。尽管这项研究因患者数量和非随机、回顾性设计而效能有限,但数据表明患者可以耐受齐多夫定与抗分枝杆菌药物的联合治疗,且不会出现不可接受的毒性。