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最新研究将耐多药/广泛耐药结核病的24个月治疗转变为6个月治疗。

Newer research transforming 24-month treatment of MDR/XDR-TB TO 6 months.

作者信息

Jain Nitin, Sharma Divyam, Jain Nirmal Kumar

机构信息

Department of Interventional Pulmonology and Respiratory Medicine, Jain Chest Care Center, Jaipur, Rajasthan, India.

Department of Respiratory Medicine, Jain Chest Care Center, Jaipur, Rajasthan, India.

出版信息

Lung India. 2025 Mar 1;42(2):140-146. doi: 10.4103/lungindia.lungindia_431_24. Epub 2025 Feb 27.

Abstract

Tuberculosis (TB) is a global threat to public health and remains the second leading infectious cause of death from a single infectious agent in 2022. According to the global tuberculosis report 2023, an estimated 10.6 million people developed TB in 2022 and 1.3 million died from the disease. About 4,10,000 new cases of multidrug-resistant/rifampicin-resistant tuberculosis (MDR/RR-TB) emerged in 2022. This huge burden has been recognised by World Health Organisation (WHO) by launching the End-TB strategy. The United Nations (UN) is committed to end TB epidemic globally by the year 2030; the aim is to reduce TB incidence by 80% and TB deaths by 90%. To eliminate the catastrophic cost, the Prime Minister of India has announced an ambitious plan to eliminate the TB in India by 2025, 5 years ahead of UN targets by ensuring quality health care and advanced treatment. Responding to the challenge of TB and drug-resistant tuberculosis, WHO is regularly issuing evidence-based guidelines using the International Grading of Recommendations Assessment, Development and Evaluation approach to assessment of new scientific evidence. Major advances have been reported in newer drugs and impact making research for new regimens in recent years. National Tuberculosis Elimination Programme has adopted effective interventions and technologies for diagnosis, treatment, and care of TB giving a new hope for elimination of TB. The present article reviews the new impact making research transforming traditional 18 to 24 months treatment of MDR/XDR TB to 6 months treatment.

摘要

结核病是对全球公共卫生的一大威胁,在2022年仍是单一传染源导致死亡的第二大主要传染病病因。根据《2023年全球结核病报告》,2022年估计有1060万人感染结核病,130万人死于该病。2022年出现了约41万例耐多药/利福平耐药结核病(MDR/RR-TB)新病例。世界卫生组织(WHO)通过启动终止结核病战略认识到了这一巨大负担。联合国(UN)致力于到2030年在全球范围内终结结核病流行;目标是将结核病发病率降低80%,结核病死亡人数降低90%。为消除灾难性费用,印度总理宣布了一项宏伟计划,即到2025年在印度消除结核病,比联合国目标提前5年,通过确保高质量医疗保健和先进治疗来实现。为应对结核病和耐药结核病的挑战,WHO定期发布基于证据的指南,采用推荐评估、制定和评价的国际分级方法来评估新的科学证据。近年来,在新药以及新治疗方案的影响性研究方面取得了重大进展。国家结核病消除计划采用了有效的干预措施和技术用于结核病的诊断、治疗和护理,为消除结核病带来了新希望。本文综述了将耐多药/广泛耐药结核病传统的18至24个月治疗转变为6个月治疗的新的影响性研究。

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Treatment of Highly Drug-Resistant Pulmonary Tuberculosis.耐多药肺结核的治疗。
N Engl J Med. 2020 Mar 5;382(10):893-902. doi: 10.1056/NEJMoa1901814.
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A Trial of a Shorter Regimen for Rifampin-Resistant Tuberculosis.一项针对耐利福平结核病的较短疗程的试验。
N Engl J Med. 2019 Mar 28;380(13):1201-1213. doi: 10.1056/NEJMoa1811867. Epub 2019 Mar 13.

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