联合用药预防结核菌素强阳性患者发病的临床意义

Clinical significance of combination therapy for prevention of disease onset in patients with strong positive tuberculin

目的探讨联合用药对结核菌素强阳性患者的方便、有效、可接受性强以及副反应小的预防性治疗方案。方法对结核菌素强阳性的患者采用联合用药的方式,即分别使用异烟肼和利福喷汀、利福喷汀和吡嗪酰胺、异烟肼方案。结果 A、B、C组结核菌素强阳性患者对于治疗方案的接受率分别为83.6%、87.6%、62.5%;完成疗程率分别为88.9%、94.4%、63.2%;副反应发生率分别为7.8%、9.2%、6.4%。结核病2年复发率分别为9‰、7‰、10‰。结论采用异烟肼和利福喷汀与利福喷汀和吡嗪酰胺以3个月间歇方法对预防结合菌素强阳性患者的发病是可行的。

Objective To investigate the preventative treatment regimen of combination therapy that is convenient,effective,acceptable and causing small side effect to the patients with strong positive tuberculin. Methods The patients with strong positive tuberculin were given combination drug therapy,isoniazide and rifapentine, rifapentine and pyrazinamide and isoniazide. Results For the patients with strong positive tuberculin in group A,B,C,the acceptance rates to treatment regimen was 83.6% ,87.6% ,and 62.5% respectively,the complete treatment rates was 88.9% ,94.4% ,and 63.2% respectively,and the incidences of adverse reactions was 7.8%,9.2%,and 6.4% respectively.The 2-year morbidity rates of tuberculosis were 9%v,7%e,and 10%. Conclusion The application of isoniazid and rifapentine,and pyrazi- namide and rifapentine intermittently within 3 months is feasible for the prevention of disease onset in patients with strong positive tuberculin.