Kajiki A
National Ohmuta Hospital, Fukuoka, Japan.
Kekkaku. 1994 Feb;69(2):107-12.
To re-evaluate pyrazinamide (PZA) which has been a key drug for short course anti-tuberculosis chemotherapy in the world, we started a clinical trial of short course chemotherapy containing PZA (2S (E) HRZ/EHR), and obtained information about the estimation of PZA in the tuberculosis specialists in Japan through a questionnaire. We could not evaluate precisely because of small numbers of registered cases, but the rate of negative conversion by culture was higher at the second months in the PZA group than in the control group. Although the total incidence of the adverse reactions of any kind was higher in the PZA group, the incidence of liver dysfunction was lower in the PZA group. Only about 20% of the tuberculosis specialists choose PZA in the treatment of newly diagnosed tuberculosis patients. The remainder do not choose PZA because they think that; 1) PZA has adverse reactions, 2) PZA is effectless, 3) drugs other than PZA are good enough. Almost half of the tuberculosis specialists continues antituberculosis chemotherapy for more than 9 months. The precise and strict nation-wide co-operative study for PZA should be designed to clarify the usefulness of PZA.
为了重新评估吡嗪酰胺（PZA）这一全球短程抗结核化疗的关键药物，我们开展了一项含PZA的短程化疗临床试验（2S（E）HRZ/EHR），并通过问卷调查获取了日本结核病专家对PZA评估的相关信息。由于登记病例数量较少，我们无法进行精确评估，但PZA组在第二个月时培养转阴率高于对照组。尽管PZA组各类不良反应的总发生率较高，但其肝功能障碍的发生率较低。仅有约20%的结核病专家在治疗新诊断的结核病患者时选择PZA。其余专家不选择PZA的原因在于：1）PZA有不良反应；2）PZA无效；3）除PZA外的其他药物已足够有效。几乎一半的结核病专家将抗结核化疗持续9个月以上。应该设计精确且严格的全国性合作研究来阐明PZA的有效性。
