Zierski M, Bek E
Tubercle. 1980 Mar;61(1):41-9. doi: 10.1016/0041-3879(80)90060-4.
An analysis is presented of the side effects which occurred in 530 patients treated with 6 months chemotherapy for newly detected pulmonary tuberculosis. Five treatment regimens were used. The initial phase of treatment consisted of daily isoniazid, rifampicin and ethambutol (HRE) or isoniazid, rifampicin, streptomycin and pyrazinamide (HRSZ) given for 2 months. The second phase of treatment consisted of isoniazid and rifampicin given twice weekly (H2R2) or isoniazid, rifampicin and ethambutol given daily (4HRE) or intermittently (H1R1E1 or H2R2E2) for 4 months. Side effects were detected in 66 (12.4%) patients. Hepatotoxic reactions occurred in 48 (9%) patients, mainly of amild and transient nature and the majority were attributable to isoniazid. The 'flu like' syndrome occurred in only 2 patients both during the daily phase of treatment, and it was not encountered in patients taking rifampicin intermittently (dose 600 mg). Inclusion of pyrazinamide in the initial phase of 1 regimen did not result in an increase of frequency of side effects. In 56% of patients on pyrazinamide the serum uric acid concentration was elevated but there was no arthralgia. Drug toxicity leading to alteration or withdrawal of treatment occurred in only 10 (1.8%) patients. This study shows that with these 6 month regimens the overall risk of drug toxicity was low, and less than that associated with more conventional treatment regimens.
对530例新发现的肺结核患者进行6个月化疗所出现的副作用进行了分析。采用了五种治疗方案。治疗的初始阶段包括每日给予异烟肼、利福平及乙胺丁醇（HRE），或异烟肼、利福平、链霉素及吡嗪酰胺（HRSZ），为期2个月。治疗的第二阶段包括每周两次给予异烟肼和利福平（H2R2），或每日（4HRE）或间歇给予（H1R1E1或H2R2E2）异烟肼、利福平及乙胺丁醇，为期4个月。66例（12.4%）患者检测到有副作用。48例（9%）患者出现肝毒性反应，主要为轻度和短暂性，大多数归因于异烟肼。仅2例患者在每日治疗阶段出现“流感样”综合征，间歇服用利福平（剂量600mg）的患者未出现该综合征。在1种方案的初始阶段加入吡嗪酰胺并未导致副作用发生率增加。服用吡嗪酰胺的患者中56%血清尿酸浓度升高，但无关节痛。仅10例（1.8%）患者因药物毒性导致治疗改变或停药。本研究表明，采用这些6个月的治疗方案，药物毒性的总体风险较低，且低于更传统的治疗方案。
