含利福平联合化疗方案治疗脑卒中并肺结核患者的疗效及安全性观察

The efficacy and safety of chemotherapy regimens including rifampin in treatment of stroke complicated with tuberculosis

目的探讨含利福平联合化疗方案治疗脑卒中合并肺结核患者的临床疗效及安全性。方法选取2010-08—2014-07我院收治的脑卒中合并肺结核患者196例,按随机数字表分成观察组与对照组各98例。对比2组治疗方案的临床疗效,监测2组患者肝功能变化情况、药物性肝损伤发生率、药物性肝损伤程度、出现肝损伤的时间及其主要的临床症状等。结果抗结核治疗后观察组患者的总体有效率77.55%（76/98）明显高于对照组55.10%（54/98）;观察组的肝损伤发生率13.27%明显小于对照组32.65%,差异具有统计学意义（P〈0.05）。ALT〉120-200U/L、ALT〉200U/L和TBIL〉34.2μmol/L观察组患者的肝损伤程度明显比对照组低,差异均具有统计学意义（P〈0.05）;但ALT 80-U/L2组患者区别不大,差异无统计学意义（P〉0.05）。2组患者出现药物性损伤的时间大多集中在8周内,差异无统计学意义（P〉0.05）。结论含利福平联合化疗方案对脑卒中合并肺结核患者的疗效好,肝功能损害小,安全性较高,值得临床应用推广。

Objective To explore the efficacy and safety of chemotherapy regimens including rifampin in treatment of stroke complicated with tuberculosis. Methods 196 cases with pulmonary tuberculosis and stroke from August 2010 to July 2014 in our hospital were chosen and divided into observation group and control group according to random number table ,98 cases in each group. The efficacy ,change of liver function ,incidence and onset of drug‐induced liver disease ,and the main symptom were monitored and compared in two groups before and after treatment. Results After anti‐tuberculosis treatment , total effective rate of 77.55% （76/98） in the observation group was significantly higher than 55.10% （54/98） in the control group. The incidence of liver damage in observation group was 13.27% ,which was obviously less than 32.65% in the control group ,with a statistical difference （P〈0.05）. The value of ALT more than 120 U/L ,ALT more than 200 U/L and TBIL more than 34.2 μmol/L in observation group was obviously lower than that in the control group ,and the differences were sta‐tistically significant （P〈0.05）;but the ALT less than 80 U/L in two groups showed no significant difference （P〉0.05）. The onset of drug‐induced injury in two groups all occurred at 8 weeks ,with no significant difference （P〉 0.05）. Conclusion Chemotherapy regimens including rifampin has a curative effect on stroke complicated with tuberculosis ,with small liver func‐tion damage and high security ,which should be worthy of clinical application.