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[耐多药结核病治疗中不良反应的发生频率及处理]

[THE FREQUENCIES AND MANAGEMENT OF ADVERSE REACTIONS IN MULTI-DRUG RESISTANT TUBERCULOSIS TREATMENT].

作者信息

Sasaki Yuka, Yoshiyama Takashi, Okumura Masao, Morimoto Kouzo, Miyamoto Maki, Yoshimori Kouzo, Kurashima Atsuyuki, Ogata Hideo, Gotoh Hajime

出版信息

Kekkaku. 2017 Jan;92(1):11-19.

Abstract

[Objectives] To investigate the adverse reactions of antimicrobial drugs in multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR- TB) patients. [Results] Sixty-six patients with MDR-TB who have been treated from 2010 through 2014 were evaluated in the retro- spective analysis. Variety of adverse reactions including psychological reaction, central nervous system toxicity, ophthalmic toxicity, peripheral neurotoxicity, gastrointestinal reactions, hematologic abnormalities, musculoskeletal adverse effects, and endocrine disorder, were observed. However, there was no fatal case due to the adverse reactions of the anti-tubercu- losis drugs in this observation. [Conclusions] Drugs for MDR-TB and XDR-TB treatment are limited and the adverse reactions of drugs for MDR-TB and XDR-TB are not well-known. Therefore, the treatment may fail due to inappropriate management of adverse events. MDR-TB and XDR-TB should be treated by the experts of the adverse reactions of all anti-tuberculosis drugs.

摘要

[目的] 探讨耐多药结核病(MDR-TB)和广泛耐药结核病(XDR-TB)患者使用抗菌药物的不良反应。[结果] 对2010年至2014年接受治疗的66例MDR-TB患者进行回顾性分析。观察到多种不良反应,包括心理反应、中枢神经系统毒性、眼部毒性、周围神经毒性、胃肠道反应、血液学异常、肌肉骨骼不良反应和内分泌紊乱。然而,在本观察中,未出现因抗结核药物不良反应导致的死亡病例。[结论] 用于治疗MDR-TB和XDR-TB的药物有限,且MDR-TB和XDR-TB药物的不良反应尚不为人所知。因此,由于对不良事件管理不当,治疗可能失败。MDR-TB和XDR-TB应由熟悉所有抗结核药物不良反应的专家进行治疗。

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