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[在阿尔及尔的常规实践中,比较三种每日化疗方案治疗肺结核六个月的对照研究。30个月时的结果]

[Controlled study comparing 3 daily chemotherapy regimens for six months in pulmonary tuberculosis in routine practice in Algiers. Results at 30 months].

作者信息

Mazouni L, Tazir M, Boulahbal F, Chaulet P

出版信息

Rev Mal Respir. 1985;2(4):209-14.

PMID:3937189
Abstract

Three anti-tuberculous regimens were compared in Algiers. The three regimens use Isoniazid and Rifampicin every day for six months; two of them used a third drug, Ethambutol or Pyrazinamide for the first three months. The results at 12 months after cessation of chemotherapy have already been reported. At 30 months (or 24 months after the end of treatment) the results were analysed for 513 cases: in 27 cases (5%) there was a relapse or therapy failed. Of 21 relapses 13 occurred in the first six months of follow up, four during the next six months, three during the third and one in the final six months. No further relapse was seen between the thirtieth and forty second months. All the cases of failure or relapse had received an additive chemotherapy. Two patients were on chemotherapy again for a relapse noted in under six months; the other 25 patients had a satisfactory outcome after receiving a regime of six to 12 months containing Rifampicin in 21 cases or a regime 12 months without Rifampicin in four cases. There was no statistically significant difference between the three therapeutic series for those cases with tubercle bacilli initially sensitive to the antituberculous drugs. On the other hand, for primary Isoniazid resistance a third drug is essential during the initial treatment. In the overall analysis pyrazinamide was as effective as Ethambutol in avoiding failure due to primary drug resistance and relapses up to 30 months.

摘要

在阿尔及尔对三种抗结核治疗方案进行了比较。这三种方案均每天使用异烟肼和利福平,疗程为六个月;其中两种方案在最初三个月还使用了第三种药物,即乙胺丁醇或吡嗪酰胺。化疗停止12个月后的结果已作报道。在30个月(或治疗结束后24个月)时,对513例病例的结果进行了分析:27例(5%)出现复发或治疗失败。在21例复发病例中,13例发生在随访的前六个月,4例发生在接下来的六个月,3例发生在第三个六个月,1例发生在最后六个月。在第30至42个月期间未再出现复发情况。所有治疗失败或复发的病例均接受了强化化疗。两名患者因在六个月内出现复发而再次接受化疗;其他25例患者在接受了含利福平的6至12个月疗程(21例)或不含利福平的12个月疗程(4例)后,病情得到满意控制。对于结核杆菌最初对抗结核药物敏感的病例,三个治疗组之间无统计学显著差异。另一方面,对于原发性异烟肼耐药病例,初始治疗期间必须使用第三种药物。总体分析表明,在避免因原发性耐药导致的治疗失败和至30个月的复发方面,吡嗪酰胺与乙胺丁醇效果相当。

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