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一项关于结核病化疗的两种每周两次和一种每周一次持续治疗方案的研究,包括两种治疗疗程的比较。2. 第二次报告:36个月时的结果。

A study of two twice-weekly and a once-weekly continuation regimen of tuberculosis chemotherapy, including a comparison of two durations of treatment. 2. Second report: the results at 36 months.

出版信息

Tubercle. 1977 Sep;58(3):129-36. doi: 10.1016/0041-3879(77)90013-7.

Abstract

The final results of a controlled clinical trial of 3 chemotherapeutic regimens in pulmonary tuberculosis in Czechoslovakia are presented. Two of the regimens were based on a twice-weekly continuation regimen of streptomycin plus isoniazid, preceded by 6 weeks or 13 weeks of initial daily triple chemotherapy with streptomycin, PAS and isoniazid; the third regimen was once-weekly streptomycin plus isoniazid preceded by 13 weeks of the daily triple combination. Patients in each regimen were allocated to a total duration of treatment of 12 months or 18 months. At 3 years, the twice-weekly continuation regimen was highly satisfactory, 97% of 93 patients receiving 13 weeks of initial daily triple chemotherapy and 98% of 82 receiving 6 weeks having a favourable response. The once-weekly regimen was less satisfactory and this was largely due to the rapid acetylators of isoniazid of whom 78% of 37 had a favourable response compared with 97% of 60 slow acetylators. There was no advantage in the longer course of chemotherapy, for 95% of 129 patients receiving chemotherapy for 12 months had a favourable response compared with 95% of 143 patients receiving it for 18 months.

摘要

本文介绍了捷克斯洛伐克针对肺结核进行的3种化疗方案的对照临床试验的最终结果。其中两种方案基于链霉素加异烟肼每周两次的持续治疗方案,在此之前分别进行6周或13周的链霉素、对氨基水杨酸和异烟肼每日三联初始化疗;第三种方案是每周一次的链霉素加异烟肼,在此之前进行13周的每日三联组合治疗。每种方案的患者被分配接受12个月或18个月的总治疗时长。3年后,每周两次的持续治疗方案效果非常令人满意,接受13周每日三联初始化疗的93名患者中有97%、接受6周治疗的82名患者中有98%反应良好。每周一次的方案效果较差,这主要是由于异烟肼的快速乙酰化者,37名快速乙酰化者中有78%反应良好,而60名慢速乙酰化者中有97%反应良好。化疗疗程延长并无优势,接受12个月化疗的129名患者中有95%反应良好,接受18个月化疗的143名患者中有95%反应良好。

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