北京市大兴县1985～1999年新发涂阳病例化疗效果评价

Evaluation of the therapeutic results for new smear positive patients in Daxing County of Beijing during 1985～1999

目的 评价北京市大兴县 15年新登记初治涂阳病例不住院监督化疗的效果。方法 对1985～ 1999年 975例初治涂阳肺结核病例的治疗方案、监化、痰菌阴转、一年转归等资料进行总结分析。结果 1985～ 1989年使用 12个月传统化疗方案 ,监化率为 82 % ,疗程结束时痰菌阴转率为93% ,队列分析治愈率为 86%。 1990年以后调整为HR(L)ZS(E) 6个月短化方案 ,监化率在 97%以上 ,阴转率在 96%以上 ,队列分析治愈率在 90 %以上。结论 在地域广阔 ,人口居住分散 ,经济条件相对滞后的农村地区 ,把结核病控制工作纳入初级卫生保健 ,开展不住院监督短程化疗 ,严格执行DOTS策略 ,是当前结核病控制最有效的方法。

Objective To evaluate the results of newly registered initial treatment smear positive cases with fully supervised ambulatory chemotherapy.Methods 975 cases of initial treatment smear positive pulmonary tuberculosis registered during 1985～1999 were reviewed and analyzed including treatment regimens,supervised chemotherapy,sputum convert and cohort analysis etc..Results During 1985～1989,the 12 months treatment regimens were applied,the supervised chemotherapy rate was 82%,sputum conversion rate was 93% when the treatemtn courses completed,and cured rate was 86% by cohort analysis.Since 1990,six months short course chemotherapy regimens,HR(L)ZS(E) were used,the supervised chemotherapy rate was over 97%,sputum conversion rate was over 96%,and cured rate was more than 90% by cohort analysis.Conclusion At present,strictly conducted DOTS strategy,especially fully supervised ambulatory chemotherapy is the best way for control tuberculosis at the population decentralized,relatively poor and extensive rural areas.