Grzybowski S, Ashley M J, Pinkus G
Can Med Assoc J. 1976 Apr 3;114(7):607-11.
A trial of chemoprophylaxis to prevent reactivation of tuberculosis in persons with inactive disease who had never had adequate chemotherapy was conducted in Canada in the mid-1960s. Preventive drug treatment consisted of either isoniazid (INH) alone or INH plus para-aminosalicylic acid (PAS), for a maximum of 18 months. Long-term evaluation in 1974 of 1571 treated patients and 834 control patients demonstrated clearly the substantial and sustained value of adequate chemoprophylaxis in reducing the risk of reactivation. Among those who took INH alone for 6 months or more the annual reactivation rate was 1.2 per 1000 persons, while among those who took INH plus PAS the rate was 0.38/1000. These rates were, respectively, 70 and 90% less than the average rate in the controls, 3.9/1000. Among those who underwent chemoprophylaxis for less than 6 months the annual reactivation rate was 3.7/1000, similar to that in the controls. Cost-benefit analysis showed chemoprophylaxis to be economically sound. Despite the recent increasing application of this preventive measure, there are still many persons living in Canada who could benefit substantially from a course of chemoprophylaxis.
20世纪60年代中期，加拿大开展了一项化学预防试验，以防止既往未接受过充分化疗的非活动性疾病患者的结核病复发。预防性药物治疗包括单独使用异烟肼（INH）或INH加对氨基水杨酸（PAS），最长治疗18个月。1974年对1571例接受治疗的患者和834例对照患者进行的长期评估清楚地表明，充分的化学预防在降低复发风险方面具有显著且持续的价值。在单独服用INH 6个月或更长时间的人群中，年复发率为每1000人中有1.2例，而在服用INH加PAS的人群中，该率为0.38/1000。这些比率分别比对照组的平均比率3.9/1000低70%和90%。在接受化学预防少于6个月的人群中，年复发率为3.7/1000，与对照组相似。成本效益分析表明化学预防在经济上是合理的。尽管最近这种预防措施的应用越来越多，但加拿大仍有许多人可以从一个疗程的化学预防中大幅受益。
