长期服用抗结核药物治疗矽肺并肺结核长期带菌生存的前瞻性研究

Prospective control study on long-term taking medicine in the treatment of long-standing mycobacterium tuberculosis-carrying silicosis patients complicated with tuberculosis

目的通过前瞻性研究探讨长期服用抗结核药治疗矽肺并肺结核长期带菌生存的临床效果。方法将24例长期排菌的矽肺并肺结核患者随机分成2组,观察组11例,长期服用抗结核药物治疗,对照组13例,未能坚持规律治疗或长期服用抗结核药物治疗。结果带菌生存时间:观察组为5～18年,平均12.72年,对照组为3～6年,平均3.85年,两组比较差异具有统计学极显著意义(P<0.01);肺结核传染事件:观察组为6人次,对照组为52人次,两组比较差异具有统计学极显著意义(P<0.01);生存寿命:观察组为63～82岁,平均73.19岁,对照组为59～74岁,平均63.92岁,两组比较差异具有统计学显著意义(P<0.05)。结论矽肺合并肺结核长期带菌患者长期服用抗结核药治疗,可以有效地延长患者的带菌生存时间及生存寿命,减少肺结核传染事件发生,矽肺合并肺结核长期排菌患者应坚持长期服用抗结核药物治疗。

Objective To prospectively probe into the clinical effect of long-term anti-tuberculosis drugs in the treatment of long-term mycobacterium tuberculosis-carrying silicosis patients complicated with tuberculosis. Methods Twenty-four cases of long-standing mycobacterium tuberculosis silicosis complicated with tuberculosis were randomly divided into two groups ： observation group and control group. The former included 11 cases with taking anti-tuberculosis drugs in a long term ;the latter included 13 cases with clinical follow up but without taking anti-tuberculosis drugs in a long term. Results Survival time with mycobacterium tuberculosis：5 - 18 living years in the observation group, average 12. 72 years,3 -6 years in the control group, average 3.85 years, the comparison between the two groups had a very significant difference （P 〈 0. 01 ）. Infectious case of tuberculosis ：6 cases in the observation group, 52 cases in the control group, the comparison between the two groups had a very significant difference （ P 〈 0. 01 ） ; Survival life time：the observation group was 63 - 82 years old, average 73.19 years old, the control group was 59 - 74 years old, average 63.92 years old, the comparison between the two groups had a significant difference （P 〈 0. 05）. Conclusion Long term taking the anti-tuberculosis medicines is one of the effective ways in the treatment of long- term mycobacterium tuberculosis-carrying silicosis patients complicated with pulmonary tuberculosis, It may lengthen the patient＇s survival time with mycobacterium tuberculosis and survival life effectively, and reduce tuberculosis in- fectious case to occur, It should be used as one of the effective prevention and control measures to long-standing mycobacterium tuberculosis silicosis complicated with tuberculosis.