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[儿童耐药结核病的临床特征及治疗效果]

[Clinical characteristics and therapeutic effect of drug-resistant tuberculosis in children].

作者信息

Liao Q, Tan S, Zhu Y, Wan C M, Deng S Y, Shu M

机构信息

Department of Pediatrics, West China Second Hospital, Sichuan University Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Sichuan University, Chengdu 610041, China.

出版信息

Zhonghua Er Ke Za Zhi. 2017 Feb 2;55(2):100-103. doi: 10.3760/cma.j.issn.0578-1310.2017.02.009.

Abstract

To explore the clinical characteristics of drug-resistant tuberculosis (TB) in children and to study the effectiveness of second-line anti-TB therapy for children and to examine the incidence of adverse drug reactions. Retrospective research was conducted. The clinical records of children in West China Second Hospital diagnosed as drug-resistant TB from January 2010 to June 2014 were investigated.The clinical characteristics and risk factors were analyzed retrospectively. Treatment effect at discharge was examined as a short-term outcome indicator to evaluate the effectiveness of second-line anti-TB therapy and the incidence of adverse drug reactions. χ(2) test was used. Forty-six patients were diagnosed as drug-resistant TB in 443 children infected with TB, with a 10.4% resistance rate. The 46 children included 26 male and 20 female patients, aged from one month and 28 days to 17 years and 5 months, with the average age (8.4±4.5) years, >7 to 14 years old patients as the biggest part(25 patients, 54.3%). Among the 46 children, 20 patients(43.5%)had close contact with TB patients, of whom 12 patients (60.0%) contacted with family members (including parents, brothers and sisters and grandparents living together) and 8 patients(40.0%) contacted with patients from outside family (such as relatives or neighbors). Moreover, 11 cases (23.9%) were under initial treatment and 35 cases (76.1%) were retreated.From 2010 to 2014, the number of cases of initial and retreated patients had no significant difference(0 and 1, 1 and 13, 4 and 7, 4 and 11, 2 and 3 cases, χ(2)=3.255, =0.196). Among retreated patients, 31.4% (11/35) had irregular treatment before.Until discharge, the effective rate was 87.0% (40/46), while the incidence rate of adverse drug reaction was 10.9%(5/46). The therapy for drug-resistant TB is effective and the incidence of adverse drug reaction is relatively low.

摘要

探讨儿童耐药结核病的临床特征,研究儿童二线抗结核治疗的有效性,并观察药物不良反应的发生率。进行回顾性研究。调查了2010年1月至2014年6月在华西第二医院诊断为耐药结核病的儿童的临床记录。对临床特征和危险因素进行回顾性分析。将出院时的治疗效果作为短期结果指标,以评估二线抗结核治疗的有效性和药物不良反应的发生率。采用χ(2)检验。443例结核感染儿童中,46例被诊断为耐药结核病,耐药率为10.4%。46例儿童中,男26例,女20例,年龄从1个月28天至17岁5个月,平均年龄(8.4±4.5)岁,7至14岁患者占比最大(25例,54.3%)。46例儿童中,20例(43.5%)与结核病患者有密切接触,其中12例(60.0%)与家庭成员(包括父母、兄弟姐妹及共同居住的祖父母)接触,8例(40.0%)与家庭外患者(如亲戚或邻居)接触。此外,11例(23.9%)为初治患者,35例(76.1%)为复治患者。2010年至2014年,初治和复治患者数量无显著差异(0例和1例,1例和13例,4例和7例,4例和11例,2例和3例,χ(2)=3.255,P =0.196)。复治患者中,31.4%(11/35)既往治疗不规律。至出院时,有效率为87.0%(40/46),药物不良反应发生率为10.9%(5/46)。耐药结核病治疗有效,药物不良反应发生率相对较低。

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