耐多药结核病化疗药物的基本选择

The baseline selection of chemotherapy of multidrug-resistant tuberculosis

耐多药结核病(MDR-TB)指的是致病结核菌至少同时耐异烟肼(INH)和利福平(RFP)。据报道,全世界约有三分之二的结核病人处于发生耐多药结核病的危险之中;我国耐多药结核病的流行也相当严重,截止2000年初始,获得耐多药率仍分别高达7.6％和17.1％。耐多药结核病已成为结核病控制中急待解决的问题。迄今为止,MDR-TB的化学治疗仍处于一个投入与产出明显不成比例的状态,表现为高治疗费用、高不良反应、长程治疗和低治疗效果,需要进一步积累经验和研究新的药物。本文根据近期相关的研究进展,就耐多药结核病化疗药物的基本选择向读者作一专题介绍,供各位同道在临床实践中参考。

Multi-drug resistant tuberculosis (MDR-TB) refers to tuberculous mycobacteria resist to at least isoniazid and rifampicin. According to reports, two thirds of global tuberculous patients are at high risk of MDR-TB, of which the epidemic in our country also remains serious. Until 2000, the frequencies of primary and acquired MDR shot to 7.6%, 17.1%,respectively. So MDR-TB has become an urgent mishap to be assailed. Up to now, the investment and output relating to chemotherapy of MDR-TB has been obviously unproportional, showing high cost, plenty side reactions, long treating teams while low treating effects, experience and novel drugs are needed desperately. This essay focused on the baseline selection of chemotherapy of MDR-TB according to recent advancement of studies, so as to be consulted for other clinicians.