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First Line Anti-Tuberculosis Drugs Resistance Patterns of <i>Mycobacterium tuberculosis</i>Isolates from Newly Diagnosed Cases of Tuberculosis
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作者 Yogita Mistry Sangita Rajdev Summaiya Mullan 《Open Journal of Medical Microbiology》 2017年第3期67-75,共9页
Introduction: Tuberculosis is a major cause of mortality and morbidity world-wide. Anti-tuberculosis drugs have been used for many decades but resistance to them is now widespread. Globally 5% of tuberculosis cases an... Introduction: Tuberculosis is a major cause of mortality and morbidity world-wide. Anti-tuberculosis drugs have been used for many decades but resistance to them is now widespread. Globally 5% of tuberculosis cases and in India 3% among new TB cases. This study was planned to know the pattern of first line anti-tuberculosis drug resistance in south Gujarat, Surat region in newly diagnosed patients of tuberculosis. Material and Methods: 350 samples were processed for homogenisation and concentration using 4% NAOH-2.9% trisodium citrate. Processed samples were inoculated in liquid medium that is MGIT (Mycobacterial growth indicator tube). Positive samples for M. tbwere processed further for first line anti-tuberculosis drugs sensitivity testing (DST). Reading was taken by using MicroMGIT system. Result: Out of 350 samples 59 (17%) were positive samples, of which 48 (13%) were M. tb and 11 (3%) were non tuberculous mycobacteria. Out of 48 samples 2% (1 isolate) was resistant to isoniazid and Rifampicin while 2% were monoresistant to isoniazide, 2% monoresistant to streptomycin. No rifampicin monoresistant was detected. Conclusion: Such study may help in control of tuberculosis at regional and national level which would in turn help in planning of measures to control Multi-drug resistance tuberculosis. Continuous surveillance should be applied to know the periodic changing patterns and trend in Drug resistant tuberculosis. 展开更多
关键词 M. TUBERCULOSIS First Line anti-tuberculosis drugs MDR-TB Prevalence
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Use of Cost Effective Semi-Automated (Mannual/Micro) MGIT System over BACTEC 960 to Perform First Line Anti-Tuberculosis Drugs Sensitivity Testing
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作者 Yogita Mistry Sangita Rajdev Summaiya Mullan 《Journal of Tuberculosis Research》 2016年第4期227-234,共8页
Introduction: Multi-drug resistant tuberculosis (MDR-TB) that is the tuberculosis that is resistant to at least 2 of the first line anti-tuberculosis drugs is fatal infectious disease. Cases of MDR-TB are now increasi... Introduction: Multi-drug resistant tuberculosis (MDR-TB) that is the tuberculosis that is resistant to at least 2 of the first line anti-tuberculosis drugs is fatal infectious disease. Cases of MDR-TB are now increasing with 30,000 cases of MDR-TB reported in 2013 by national TB programme. Rapid diagnosis of MDR-TB is extremely important for rapid treatment of patient and to prevent spread of MDR-TB to other. BACTEC 960 system helps in rapid diagnosis but purchase of expensive instrument for the same is the limitation. However, the same purpose can be solved by use of semi-automated MGIT system. Aims and Objectives: Aim of this study is to do drug sensitivity testing of the first line anti-tuberculosis drugs with the use of semi-automated MGIT systems. 350 newly registered and suspected cases of tuberculosis in tertiary care hospital were included. Samples were processed for digestion and decontamination and inoculated in MGIT tubes and also on LJ medium. Reading was taken using semi-automated MGIT system. Positive tubes were confirmed by rapid test for M. tuberculosis and then drug sensitivity was performed. Result: Out of 350 samples, 62% were sputum;33% were pleural fluid and rest 5% were lymph node, Ascetic fluid, CSF, pus. Average day of positivity by MGIT was 13 - 20 days as compared to 25 - 37 days by solid medium, which was statistically significant with p value Conclusion: Manual MGIT System is a simple, efficient, safe to use diagnostic system. It does not require any expensive/special instrumentation other than the UV lamp for detection of fluorescence. The rapidity by which mycobacteria are detected is the most important advantage of the Manual MGIT. In areas with limited resources where purchase of expensive instruments such as the MGIT960 is out of scope, the use of manual MGIT for rapid susceptibility testing for MDR-TB could be a possibility. 展开更多
关键词 Semi-Automated MGIT System MDR-TB First-Line anti-tuberculosis drugs
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Pyrrolidine dithiocarbamate alleviates the anti-tuberculosis drug-induced liver injury through JAK2/STAT3 signaling pathway:An experimental study 被引量:10
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作者 Hong Zhang Yang Liu +1 位作者 Li-Kun Wang Na Wei 《Asian Pacific Journal of Tropical Medicine》 SCIE CAS 2017年第5期493-496,共4页
Objective:To study the effect of pyrrolidine dithiocarbamate(PDTC) on the anti-tuberculosis drug-induced liver injury and the molecular mechanism. Methods:Clean male SD rats were selected as experimental animals and r... Objective:To study the effect of pyrrolidine dithiocarbamate(PDTC) on the anti-tuberculosis drug-induced liver injury and the molecular mechanism. Methods:Clean male SD rats were selected as experimental animals and randomly divided into normal group,model group,PDTC group and AG490 group. Animal model of anti-tuberculosis drug-induced liver injury was established by intragastric administration isoniazid + rifampicin. PDTC group received intraperitoneal injection of PDTC,and AG490 group received intraperitoneal injection of AG490. Twenty-eight days after intervention,the rats were executed,and the liver injury indexes,inflammation indexes and oxidative stress indexes in serum as well as JAK2/STAT3 expression,liver injury indexes,inflammation indexes and oxidative stress indexes in liver tissue were determined. Results:p-JAK2,p-STAT3,TNF-α,IL-1β,IL-6,ROS,8-OHdG and MDA expression in liver tissue as well as TBIL,ALT,AST,γ-GT,TNF-α,IL-1β,IL-6,ROS,8-OHdG and MDA levels in serum of model group were significantly higher than those of normal group while p-JAK2,p-STAT3,TNF-α,IL-1β,IL-6,ROS,8-OHdG and MDA expression in liver tissu as well as TBIL,ALT,AST,γ-GT,TNF-α,IL-1β,IL-6,ROS,8-OHdG and MDA levels in serum of PDTC group and AG490 group were significantly lower than those of model group. Conclusions:PDTC can inhibit the inflammation and oxidative stress mediated by JAK2/STAT3 signaling pathway to alleviate the anti-tuberculosis drug-induced liver injury. 展开更多
关键词 drug-induced liver injury anti-tuberculosis drug Pyrrolidine dithiocarbamate JAK2 STAT3
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Research progress on the drug action and resistance mechanism in Mycobacterium tuberculosis
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作者 GE Sai SONG Xin-yi +3 位作者 JIANG Hui-yue LI Zhao-yang ZHU Zhuang-yan SUN Man-luan 《Journal of Hainan Medical University》 CAS 2023年第24期58-66,共9页
Tuberculosis(TB)is a chronic infectious disease caused by Mycobacterium Tuberculosis(MTB).It is the second largest single cause of death besides novel coronavirus pneumonia.Along with the abuse of antibiotics and exte... Tuberculosis(TB)is a chronic infectious disease caused by Mycobacterium Tuberculosis(MTB).It is the second largest single cause of death besides novel coronavirus pneumonia.Along with the abuse of antibiotics and extensive use of anti-tuberculosis drugs,multidrug-resistant(MDR)TB,drug-resistant(XDR)TB and totally drug-resistant(TDR)TB became obstacles to the tuberculosis eradication worldwide.According to the World Health Organization(WHO)statistics,China is not only a high burden tuberculosis country in the world,but also a country with a serious epidemic of MDR.Traditional drugs fail to meet the needs of tuberculosis control.Therefore,it is urgent to find new targets of anti-tuberculosis drugs and develop new anti-tuberculosis drugs.Hence,this paper systematically summarizes the mechanism of traditional and newly developed anti-tuberculosis drugs,in which stressing the research progress of drug resistance mechanisms.This work provides us with new insights of new anti-tuberculosis drug developments,and may contribute to a reduction in the harm that tuberculosis brings to society. 展开更多
关键词 anti-tuberculosis drugs Mycobacterium tuberculosis Resistance mechanism Multidrug resistance tuberculosis
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黄连素+四联疗法治疗幽门螺杆菌阳性消化性溃疡的临床效果分析
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作者 李毅 李坚 《中国现代药物应用》 2024年第15期80-82,共3页
目的探究黄连素(别称:盐酸小檗碱)与四联疗法联合用药方案治疗幽门螺杆菌(Hp)阳性消化性溃疡的临床效果,为临床医师选择合理用药方案提供参考。方法204例Hp阳性消化性溃疡患者为研究对象,采用随机数字表法分为对照组和观察组,每组102例... 目的探究黄连素(别称:盐酸小檗碱)与四联疗法联合用药方案治疗幽门螺杆菌(Hp)阳性消化性溃疡的临床效果,为临床医师选择合理用药方案提供参考。方法204例Hp阳性消化性溃疡患者为研究对象,采用随机数字表法分为对照组和观察组,每组102例。对照组患者接受常规四联疗法治疗,观察组采用黄连素与四联疗法联合治疗。比较两组患者症状改善时间、Hp清除率及复发率、临床治疗效果、不良反应发生率。结果观察组患者反酸、嗳气、腹痛消失时间与溃疡愈合时间分别为(2.95±0.51)、(3.85±0.44)、(5.65±0.88)、(8.74±0.85)d,较对照组的(4.35±0.85)、(6.85±0.61)、(7.51±1.38)、(12.45±1.28)d短(P<0.05)。观察组患者Hp清除率及复发率分别为96.1%、3.9%,对照组患者分别为80.4%、17.6%,两组比较,观察组患者Hp清除率高,复发率低(P<0.05)。观察组患者治疗总有效率为98.0%,对照组为90.2%,两组比较,观察组较高(P<0.05)。观察组患者不良反应发生率为2.0%(2/102),与对照组的3.9%(4/102)比较无差异(P>0.05)。结论对Hp阳性消化性溃疡患者实施四联疗法治疗时联合黄连素可以快速改善临床症状,提升治疗效果,同时还能提高Hp清除率,降低复发率,值得推广。 展开更多
关键词 幽门螺杆菌 消化性溃疡 黄连素 四联疗法 联合用药 临床疗效
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“新四联”药物对射血分数保留慢性心力衰竭患者的心功能、血流动力学及微RNA水平的影响
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作者 张亮 王京艳 +1 位作者 周晓妮 赵卉 《临床和实验医学杂志》 2024年第8期793-797,共5页
目的探讨“新四联”药物对射血分数保留心力衰竭患者的心功能、血流动力学及微RNA(miRNA)水平的影响。方法回顾性选取2019年1月至2023年1月运城市中心医院心内科收治的射血分数保留慢性心力衰竭患者123例作为研究对象,按治疗方式的不同... 目的探讨“新四联”药物对射血分数保留心力衰竭患者的心功能、血流动力学及微RNA(miRNA)水平的影响。方法回顾性选取2019年1月至2023年1月运城市中心医院心内科收治的射血分数保留慢性心力衰竭患者123例作为研究对象,按治疗方式的不同分为对照组(n=61)和观察组(n=62)。对照组在降压、降糖、抗心力衰竭、降脂等常规对症治疗基础上,行“金三角”[血管紧张素转化酶抑制剂(ACEI)/血管紧张素Ⅱ受体拮抗剂(ARB)+β受体阻滞剂+醛固酮受体拮抗剂(MRA)]治疗。观察组在常规治疗基础上予以“新四联”[血管紧张素受体脑啡肽酶抑制剂(ARNI)或ACEI/ARB+钠-葡萄糖协同转运蛋白2(SGLT2i)+β受体阻滞剂+MRA]药物治疗。比较两组治疗前、治疗后1个月的心功能指标[左心室射血分数(LVEF)、左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD)]和血流动力学指标[左前降支收缩期峰流速(SPV)、舒张期峰流速(DPV)、时间速度积分(TVI)]及外周血miRNA-499、miRNA-30a水平等指标差异。比较两组患者心血管病死率及再入院率。结果治疗后1个月,两组LVEF均高于治疗前,LVESD、LVEDD均低于治疗前,观察组的LVEF为(65.62±8.69)%,高于对照组[(54.25±8.64)%],LVESD、LVEDD分别为(55.36±7.62)、(40.31±6.56)mm,均低于对照组[(61.47±7.25)、(46.72±7.12)mm],差异均有统计学意义(P<0.05)。治疗后1个月,两组SPV、DPV、TVI均高于治疗前,且观察组的SPV、DPV、TVI分别为(17.65±1.34)cm/s、(32.48±3.15)cm/s、(23.58±1.26)分,均高于对照组[(15.40±1.36)cm/s、(29.42±3.12)cm/s、(20.34±1.25)分],差异均有统计学意义(P<0.05)。治疗后1个月,两组miRNA-499、miRNA-30a水平均低于治疗前,且观察组治疗后1个月的miRNA-499、miRNA-30a分别为1.65±0.22、0.11±0.06,均低于对照组(1.89±0.29、0.14±0.06),差异均有统计学意义(P<0.05)。两组心血管病死率比较,差异无统计学意义(P>0.05);观察组患者的再入院率为4.84%,显著低于对照组(14.75%),差异有统计学意义(P<0.05)。结论“新四联”药物可改善射血分数保留心力衰竭的患者的心功能,调节冠状动脉血流动力学,降低miRNA-30a和miRNA-499水平,对机体康复有益。 展开更多
关键词 心力衰竭 微RNA “新四联”药物 射血分数保留心力衰竭 收缩期峰流速 舒张期峰流速 时间速度积分
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抗痨清脑汤联合四联抗结核药对结核脑膜炎的疗效
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作者 杨博 曹颖 +1 位作者 梁峰 蒋超 《西北药学杂志》 2024年第1期106-110,共5页
目的探讨抗痨清脑汤联合四联抗结核药对成人结核性脑膜炎的治疗效果。方法选取121例结核性脑膜炎患者,用随机数字表法分为观察组(60例)和对照组(61例)。对照组服用四联抗结核药物,观察组在对照组治疗的基础上加用抗痨清脑汤,所有患者均... 目的探讨抗痨清脑汤联合四联抗结核药对成人结核性脑膜炎的治疗效果。方法选取121例结核性脑膜炎患者,用随机数字表法分为观察组(60例)和对照组(61例)。对照组服用四联抗结核药物,观察组在对照组治疗的基础上加用抗痨清脑汤,所有患者均持续治疗60 d,出院后随访3个月。治疗前后检测患者脑脊液肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、早期分泌性靶抗原-6(early secreting antigenic target-6,ESAT-6)、干扰素-γ(interferon-γ,IFN-γ)和白细胞介素-23(interleukin-23,IL-23)、白细胞介素-10(interleukin-10,IL-10)、乳酸脱氢酶(lactate dehydrogenase,LDH)以及β_(2)微球蛋白(β_(2)-microglobulin,β_(2)-MG)水平,用中医证候积分对患者的症状进行评价;观察患者治疗期间的临床指标,包括住院时间以及头痛、发热和恶心呕吐等症状消失时间;观察并记录2组患者的治疗总有效率和不良反应发生率。结果治疗后,2组患者脑脊液TNF-α、LDH、β_(2)-MG、ESAT-6、IL-23、IL-10、INF-γ水平和中医证候积分均下降,且观察组低于对照组(P<0.05);观察组患者头痛、发热、恶心呕吐症状消失时间及住院时间均短于对照组(P<0.05);观察组患者的治疗总有效率高于对照组(P<0.05);2组不良反应发生率比较差异无统计学意义(P>0.05)。结论抗痨清脑汤联合四联抗结核药可有效缓解结核性脑膜炎成人患者的临床症状,改善脑脊液TNF-α和β_(2)-MG水平,且安全性高。 展开更多
关键词 四联抗结核药 结核性脑膜炎 抗痨清脑汤 脑脊液
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Drug Resistance Pattern in Pulmonary Tuberculosis Patients and Risk Factors Associated with Multi-Drug Resistant Tuberculosis 被引量:3
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作者 S. Maharjan A. Singh +1 位作者 D. K. Khadka M. Aryal 《Journal of Tuberculosis Research》 2017年第2期106-117,共12页
Introduction: Anti-tuberculosis drug resistance is a major problem in tuberculosis (TB) control programme, particularly multi-drug resistance TB (MDR-TB) in Nepal. Drug resistance is difficult to treat due to its asso... Introduction: Anti-tuberculosis drug resistance is a major problem in tuberculosis (TB) control programme, particularly multi-drug resistance TB (MDR-TB) in Nepal. Drug resistance is difficult to treat due to its associated cost and side effects. The objective of this study was to assess the drug resistance pattern and assess risk factor associated with MDR-TB among pulmonary tuberculosis patients attending National Tuberculosis Center. Methodology: The comparative cross sectional study was conducted at National Tuberculosis Center during August 2015 to February 2015. Early morning sputum samples were collected from pulmonary tuberculosis suspected patients and subjected to Ziehl-Neelsen staining and fluorochrome staining and culture on Lowenstein-Jensen (LJ) medium. Drug Susceptibility test was performed on culture positive isolates by using proportion method. Univariate and multivariate analysis was computed to assess the risk factors of MDR-TB. Results: Out of 223 sputum samples, 105 were fluorochrome staining positive, 85 were ZN staining positive and 102 were culture positive. Out of 102 culture positive isolates, 37.2% were resistance to any four anti-TB drugs. 11 (28.9%) were initial drug resistance and 28 (43.7%) were acquired drug resistance. The overall prevalence of MDR-TB was 11.7%, of which 2 (5.3%) were initial MDR-TB and 10 (15.6%) were acquired MDR-TB. Univariate and multivariate analysis showed female were significantly associated (P = 0.05) with MDR-TB. Conclusion: Drug resistance TB particularly MDR-TB is high. The most common resistance pattern observed in this study was resistance to both isoniazid and rifampicin. Female were found to be associated with MDR-TB. Thus, early diagnosis of TB and provision of culture and DST are crucial in order to combat the threat of DR-TB. 展开更多
关键词 TUBERCULOSIS PULMONARY TUBERCULOSIS anti-tuberculosis drug Resistance MDR-TB
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三联、四联药物方案治疗胃溃疡的临床效果对比 被引量:1
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作者 王强 赵红珍 姚义荣 《中国实用医药》 2023年第20期102-104,共3页
目的探讨胃溃疡患者分别采用三联、四联药物方案治疗的临床效果。方法96例胃溃疡患者,以抽签法分为参照组和研究组,每组48例。参照组患者采用三联药物方案治疗,研究组患者采用四联药物方案治疗。比较两组患者的治疗效果、疾病复发率、... 目的探讨胃溃疡患者分别采用三联、四联药物方案治疗的临床效果。方法96例胃溃疡患者,以抽签法分为参照组和研究组,每组48例。参照组患者采用三联药物方案治疗,研究组患者采用四联药物方案治疗。比较两组患者的治疗效果、疾病复发率、临床症状改善时间以及治疗前后胃溃疡面积、疼痛程度。结果研究组患者治疗总有效率95.83%高于参照组的79.17%,疾病复发率2.08%低于参照组的14.58%,差异具有统计学意义(P<0.05)。治疗后,研究组患者胃溃疡面积(3.11±0.03)cm^(3)小于参照组的(8.59±2.39)cm^(3),胃灼痛评分(1.06±0.15)分、上腹疼痛评分(1.02±0.13)分低于参照组的(1.79±0.39)、(1.91±0.26)分,差异具有统计学意义(P<0.05)。研究组患者反酸消失时间(1.53±0.53)d、烧灼感消失时间(1.25±0.39)d、嗳气缓解时间(2.56±0.46)d、恶心呕吐消失时间(2.39±0.25)d以及腹胀消失时间(2.42±0.65)d均短于参照组的(2.65±0.56)、(2.71±0.57)、(3.56±0.59)、(3.59±0.22)、(3.59±0.44)d,差异具有统计学意义(P<0.05)。结论与三联药物方案比较,临床采用四联药物方案治疗胃溃疡患者的效果更高,可显著降低疾病复发率,改善胃溃疡面积、疼痛程度,缩短反酸消失时间、烧灼感消失时间、嗳气缓解时间、恶心呕吐消失时间以及腹胀消失时间,值得临床推广应用。 展开更多
关键词 胃溃疡 三联药物 四联药物 治疗效果 复发 疼痛程度 临床症状改善时间
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Endogenous peroxynitrite activated fluorescent probe for revealing anti-tuberculosis drug induced hepatotoxicity 被引量:1
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作者 Nannan Wang Han Wang +5 位作者 Jian Zhang Xin Ji Huihui Su Jinying Liu Jiamin Wang Weili Zhao 《Chinese Chemical Letters》 SCIE CAS CSCD 2022年第3期1584-1588,共5页
Py^(+)razinamide (PZA), isoniazid (INH) and rifampicin (RFP) are all commonly used anti-tuberculosis drugs in clinical practice, and long-term medication may cause severe liver damage and toxicity. The level of peroxy... Py^(+)razinamide (PZA), isoniazid (INH) and rifampicin (RFP) are all commonly used anti-tuberculosis drugs in clinical practice, and long-term medication may cause severe liver damage and toxicity. The level of peroxynitrite (ONOO^(-)) generated in liver has long been regarded as a biomarker for the prediction and measurement of drug-induced liver injury (DILI). In this article, we constructed a BODIPY-based fluorescent probe (BDP-Py^(+)) that enabled quickly and sensitively detect and image ONOO^(-) in vivo. Utilizing this probe, we demonstrated the change of ONOO^(-) content in cells and mice model of DILI induced by acetaminophen (APAP), and for the first time revealed the mechanism of liver injury induced by antituberculosis drug PZA. Moreover, BDP-Py^(+) could be applied to screen out and evaluate the hepatotoxicity of different anti-tuberculosis drugs. Comparing with the existing serum enzymes detection and H&E staining, the probe could achieve early diagnosis of DILI before solid lesions in liver via monitoring the up-regulation of ONOO^(-) levels. Collectively, this work will promote the understanding of the pathogenesis of anti-tuberculosis drug induced liver injury (ATB-DILI), and provide a powerful tool for the early diagnosis and treatment of DILI. 展开更多
关键词 anti-tuberculosis drug induced liver injury PEROXYNITRITE Fluorescent probe drug-induced liver injury BIOIMAGING
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利奈唑胺治疗耐药性肺结核的临床效果和安全性评价
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作者 宋刚 《中国实用医药》 2023年第6期97-99,共3页
目的 分析利奈唑胺治疗耐药性肺结核的临床效果和安全性。方法 98例耐药性肺结核患者,采用抽签法分为参照组与研究组,每组49例。参照组给予基础治疗,研究组在参照组基础上添加利奈唑胺治疗。对比两组患者痰菌转阴率、空洞闭合率、症状... 目的 分析利奈唑胺治疗耐药性肺结核的临床效果和安全性。方法 98例耐药性肺结核患者,采用抽签法分为参照组与研究组,每组49例。参照组给予基础治疗,研究组在参照组基础上添加利奈唑胺治疗。对比两组患者痰菌转阴率、空洞闭合率、症状改善率、抗酸染色涂片阴性率及不良反应发生情况。结果 研究组患者痰菌转阴46例、占比93.88%,空洞闭合47例、占比95.92%;参照组患者痰菌转阴38例、占比77.55%,空洞闭合39例、占比79.59%。研究组痰菌转阴率、空洞闭合率明显高于参照组,差异有统计学意义(P<0.05)。研究组患者症状改善45例、占比91.84%,抗酸染色涂片阴性43例、占比87.76%;参照组患者症状改善34例、占比69.39%,抗酸染色涂片阴性35例、占比71.43%。研究组患者症状改善率、抗酸染色涂片阴性率均高于参照组,差异有统计学意义(P<0.05)。研究组患者发生恶心1例(2.04%),头晕2例(4.08%),食欲减退3例(6.12%),不良反应发生率为12.24%(6/49);参照组患者发生恶心1例(2.04%),头晕1例(2.04%),食欲减退2例(4.08%),不良反应发生率为8.16%(4/49)。两组患者不良反应发生率对比,差异无统计学意义(P>0.05)。结论 耐药性肺结核患者采用利奈唑胺治疗,能有效提高治疗有效率,不良反应少,安全性高,可在临床推广及使用。 展开更多
关键词 利奈唑胺 标准化四联 耐药性肺结核
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四联疗法根治幽门螺杆菌引发全身性药物性皮炎1例
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作者 龚亮 李恬 +3 位作者 禹钧博 周贵根 徐敏 张娜 《中国当代医药》 CAS 2023年第34期168-171,共4页
幽门螺杆菌(Hp)是人类常见的慢性细菌感染,在全球自然细菌感染中超过50%,是许多消化道疾病如慢性胃炎、消化性溃疡的主要致病因素。近年来一系列的研究表明,Hp感染会显著增加发生胃癌的风险。所以,根治Hp不但是治疗很多消化道疾病的前提... 幽门螺杆菌(Hp)是人类常见的慢性细菌感染,在全球自然细菌感染中超过50%,是许多消化道疾病如慢性胃炎、消化性溃疡的主要致病因素。近年来一系列的研究表明,Hp感染会显著增加发生胃癌的风险。所以,根治Hp不但是治疗很多消化道疾病的前提,更是预防胃癌的重要措施。我国推荐根治Hp的一线治疗方案为四联疗法(铋剂+两种抗生素+质子泵抑制剂)和大剂量二联疗法(大剂量阿莫西林+一种质子泵抑制剂),疗程一般为14 d。目前关于四联疗法根治Hp感染引发严重全身性药物性皮炎的病例报道较少,本文报道1例患者服用四联药物根治Hp期间,出现全身性红色皮疹、水泡伴皮肤瘙痒等严重过敏反应,分析该临床表现的发生与四联药物、自身体质、用药期间饮食的相关性,为临床上根治Hp规范用药和降低药物不良反应的发生提供参考。 展开更多
关键词 四联疗法 幽门螺杆菌 全身性药物性皮炎 病例报道
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分析三联、四联药物方案治疗胃溃疡的临床效果
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作者 王昌盛 陈兰 廖小红 《系统医学》 2023年第24期175-177,共3页
目的探讨胃溃疡患者选择四联药物治疗后的临床效果。方法选取2022年1月—2023年8月广东药科大学附属第一医院收治的76例胃溃疡患者为研究对象,依据投掷硬币法分组,参照组(38例)选择三联药物治疗,研究组(38例)选择四联药物治疗,比较两组... 目的探讨胃溃疡患者选择四联药物治疗后的临床效果。方法选取2022年1月—2023年8月广东药科大学附属第一医院收治的76例胃溃疡患者为研究对象,依据投掷硬币法分组,参照组(38例)选择三联药物治疗,研究组(38例)选择四联药物治疗,比较两组治疗总有效率、胃灼痛评分、胃溃疡面积、上腹疼痛评分、临床症状改善时间。结果研究组治疗总有效率为97.37%,明显高于参照组,差异有统计学意义(χ2=6.176,P<0.05)。治疗后,研究组胃灼痛评分、胃溃疡面积、上腹疼痛评分、临床症状改善时间均低于参照组,差异有统计学意义(P均<0.05)。结论同三联药物比较,胃溃疡患者接受四联药物治疗,可显著提升临床效果,有效改善疾病症状,可促进胃溃疡患者的良好预后。 展开更多
关键词 胃溃疡 三联药物 四联药物 疗效
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四联抗结核药物联合地塞米松治疗结核性渗出性胸膜炎的效果分析
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作者 杜冉 袁金星 《临床医学工程》 2023年第8期1061-1062,共2页
目的探讨四联抗结核药物联合地塞米松治疗结核性渗出性胸膜炎的效果。方法80例结核性渗出性胸膜炎患者按照入组顺序分为两组,对照组接受四联抗结核药物治疗,观察组接受四联抗结核药物+地塞米松治疗,比较两组的治疗效果、临床症状及血清... 目的探讨四联抗结核药物联合地塞米松治疗结核性渗出性胸膜炎的效果。方法80例结核性渗出性胸膜炎患者按照入组顺序分为两组,对照组接受四联抗结核药物治疗,观察组接受四联抗结核药物+地塞米松治疗,比较两组的治疗效果、临床症状及血清指标。结果观察组的总有效率高于对照组(95.00%vs.80.00%,P<0.05)。观察组的退热时间、胸水排出量、胸腔积液消退时间及治疗后胸膜厚度均低于对照组,治疗后的TNF-α、IFN-γ水平均低于对照组(P<0.05)。结论四联抗结核药物联合地塞米松治疗结核性渗出性胸膜炎的效果较好,可改善患者临床症状,调节机体免疫平衡。 展开更多
关键词 四联抗结核药物 地塞米松 结核性渗出性胸膜炎
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含铋剂和克拉霉素的四联根除方案在幽门螺杆菌一线治疗中的作用 被引量:55
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作者 徐小青 孙钦娟 +5 位作者 廖静贤 梁晓 郑青 刘文忠 萧树东 陆红 《胃肠病学》 2012年第1期5-9,共5页
背景:近年经典三联方案对幽门螺杆菌(H.pylori)感染的根除疗效明显下降,建立新型、安全和高效的一线标准治疗方案是临床工作的当务之急。目的:评估含铋剂和克拉霉素的四联方案作为H.pylori一线治疗方案的疗效和安全性。方法:120例胃镜... 背景:近年经典三联方案对幽门螺杆菌(H.pylori)感染的根除疗效明显下降,建立新型、安全和高效的一线标准治疗方案是临床工作的当务之急。目的:评估含铋剂和克拉霉素的四联方案作为H.pylori一线治疗方案的疗效和安全性。方法:120例胃镜诊断为非溃疡性消化不良的H.pylori感染患者随机分为3组:7 d三联组(奥美拉唑20 mgbid+阿莫西林1000 mg bid+克拉霉素500 mg bid,疗程7 d)、7 d四联组(7 d三联方案+枸橼酸铋钾220 mg bid,疗程7 d)和2周四联组(方案同7 d四联组,疗程2周)。治疗结束后至少4周行13C-尿素呼气试验以评估根除疗效。H.pylori分离菌株行克拉霉素、甲硝唑和阿莫西林药敏试验。结果:115例患者按方案完成治疗。7 d三联组、7 d四联组和2周四联组按意向治疗(ITT)分析H.pylori根除率分别为70.0%、75.0%和90.0%,按方案(PP)分析分别为73.7%、76.9%和94.7%。2周四联组ITT和PP根除率均显著高于7 d三联组(P<0.05),PP根除率显著高于7 d四联组(P=0.026),而7 d三联组ITT和PP根除率与7 d四联组相比均无明显差异。H.pylori对克拉霉素、甲硝唑和阿莫西林的耐药率分别为24.2%、48.3%和0%,7 d三联组、7 d四联组和2周四联组对克拉霉素耐药菌株的根除率逐渐升高(37.5%、55.6%、80.0%),但差异无统计学意义。除2周四联组中1例患者因皮肤过敏而未完成治疗外,其余患者的不良反应相似且轻微,耐受性良好。结论:含铋剂和克拉霉素的2周四联方案可明显提高H.pylori根除疗效,且安全性较高,可作为H.pylori一线治疗的标准方案。 展开更多
关键词 螺杆菌 幽门 四联方案 铋剂 克拉霉素 抗药性
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黄连素联合四联疗法在幽门螺杆菌一线治疗中的作用研究 被引量:13
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作者 徐小青 周帆 +2 位作者 吴小溪 陆娟 曹勤 《中国医药导报》 CAS 2020年第19期78-81,共4页
目的 探讨黄连素联合四联疗法作为幽门螺杆菌(Hp)一线治疗的效果和安全性.方法 收集上海中医药大学附属普陀医院2018年11月~2019年11月Hp阳性的慢性胃炎患者100例,采用随机数字表法将其分为试验组和对照组,每组50例.对照组采用四联疗法... 目的 探讨黄连素联合四联疗法作为幽门螺杆菌(Hp)一线治疗的效果和安全性.方法 收集上海中医药大学附属普陀医院2018年11月~2019年11月Hp阳性的慢性胃炎患者100例,采用随机数字表法将其分为试验组和对照组,每组50例.对照组采用四联疗法,试验组在对照组的基础上加用黄连素,评估两组根除率、临床疗效和不良反应发生率.琼脂稀释法对Hp临床分离株行三种常用抗生素的药敏试验,分析耐药性及对两组根除率的影响.结果 试验组按意向治疗分析,Hp根除率高于对照组,差异有统计学意义(P<0.05);按方案分析,两组Hp根除率比较,差异无统计学意义(P>0.05).两组临床疗效比较,差异无统计学意义(P>0.05).两组不良反应总发生率比较,差异无统计学意义(P>0.05),其中试验组恶心、腹泻的发生率明显低于对照组,差异有统计学意义(P<0.05).Hp对克拉霉素、甲硝唑和阿莫西林的耐药率分别为32.0%、64.0%、0.0%.在克拉霉素耐药菌株中,试验组根除率明显高于对照组,差异有统计学意义(P<0.05).结论 黄连素联合四联疗法可提高Hp根除率,且安全性高,可作为Hp克拉霉素高耐药地区一线治疗的可选方案. 展开更多
关键词 幽门螺杆菌 四联疗法 黄连素 克拉霉素 耐药性
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3种四联方案根除幽门螺杆菌的效果及安全性观察 被引量:8
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作者 陈菲 潘晨 +4 位作者 王瑞睿 姚怡然 王岚 刘琦 杨杰 《贵州医科大学学报》 CAS 2017年第5期588-591,共4页
目的:探索阿莫西林联合克拉霉素、四环素联合呋喃唑酮、氧氟沙星联合庆大霉素4种抗生素组合对根除幽门螺杆菌(H.Pylori)的疗效及安全性。方法:选择C14呼气试验阳性的H.pylori感染、并伴有消化不良症状患者210例,采用分段随机法分为3组,... 目的:探索阿莫西林联合克拉霉素、四环素联合呋喃唑酮、氧氟沙星联合庆大霉素4种抗生素组合对根除幽门螺杆菌(H.Pylori)的疗效及安全性。方法:选择C14呼气试验阳性的H.pylori感染、并伴有消化不良症状患者210例,采用分段随机法分为3组,A组使用阿莫西林联合克拉霉素治疗,B组使用四环素联合呋喃唑酮治疗,C组使用氧氟沙星联合庆大霉素治疗,各组均加入兰索拉唑及胶体果胶铋,疗程14 d;治疗结束4周后复查C14呼气试验,阴性者为H.pylori根除成功;记录并比较3组患者H.pylori行意向性(ITT)及符合方案(PP)根除率、症状缓解率,不良反应ITT及PP发生率。结果:与A、C两组治疗方案比较,B组ITT和PP根除率最高(P<0.05);3种治疗方案的症状缓解率均高于80%,各种治疗方案比较,差异无统计学意义(P>0.05);不良反应发生率B组最高,但3组间比较,差异无统计学意义(P>0.05),且所有不良反应均于停药后消失。结论:3种四联方案治疗H.Pylori感染并消化不良症的安全性较好,其中四环素联合呋喃唑酮方案H.pylori根除率最高。 展开更多
关键词 四环素 幽门螺杆菌 四联疗法 耐药率 根除率
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选择符合国情的幽门螺杆菌感染治疗方案 被引量:12
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作者 谢川 吕农华 《医学与哲学(B)》 2012年第5期10-11,26,共3页
我国为发展中国家,幽门螺杆菌(Hp)感染率及相关疾病的发病率高,随着Hp对克拉霉素和甲硝唑耐药率的不断升高,导致目前共识推荐的标准三联疗法Hp根除率越来越低。因此,应积极探索符合我国国情的Hp感染治疗方案。国内研究表明,含呋喃唑酮... 我国为发展中国家,幽门螺杆菌(Hp)感染率及相关疾病的发病率高,随着Hp对克拉霉素和甲硝唑耐药率的不断升高,导致目前共识推荐的标准三联疗法Hp根除率越来越低。因此,应积极探索符合我国国情的Hp感染治疗方案。国内研究表明,含呋喃唑酮和铋剂四联方案Hp根除率高,价格低廉,适合在我国推广应用。与此同时,也应重视含四环素的Hp治疗方案的研究。而序贯疗法、伴同疗法其疗效还有待于循证医学进一步验证。 展开更多
关键词 幽门螺杆菌 耐药 呋喃唑酮 四联疗法
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努力提高幽门螺杆菌根除率 被引量:12
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作者 陆红 刘文忠 《胃肠病学》 2020年第5期266-270,共5页
随着对幽门螺杆菌(Hp)感染危害认知度的提高,其根除指征不断扩大。《幽门螺杆菌胃炎京都全球共识》提出的“治疗所有Hp感染者,除非有抗衡因素”的观点已为越来越多的学者所接受,我国已将“证实有Hp感染”作为根除指征。然而,随着Hp耐药... 随着对幽门螺杆菌(Hp)感染危害认知度的提高,其根除指征不断扩大。《幽门螺杆菌胃炎京都全球共识》提出的“治疗所有Hp感染者,除非有抗衡因素”的观点已为越来越多的学者所接受,我国已将“证实有Hp感染”作为根除指征。然而,随着Hp耐药率的增加,其根除率逐渐下降,多次治疗失败者的比例不断增加。本文对Hp根除治疗相关问题进行概述,以期提高Hp感染根除率。 展开更多
关键词 幽门螺杆菌 根除率 耐药 经验治疗 铋剂四联方案 高剂量PPI-阿莫西林二联方案 药敏试验指导的治疗
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气滞胃痛颗粒联合四联药物根除幽门螺杆菌感染82例临床分析 被引量:4
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作者 邢玉娥 付丽英 《中国实用医药》 2019年第10期116-117,共2页
目的探讨气滞胃痛颗粒联合四联药物根除幽门螺杆菌(Hp)感染的临床疗效。方法 82例Hp感染患者,随机分为观察组和对照组,每组41例。观察组患者采用四联药物+气滞胃痛颗粒治疗,对照组患者仅采用四联药物治疗。观察并对比两组临床疗效以及H... 目的探讨气滞胃痛颗粒联合四联药物根除幽门螺杆菌(Hp)感染的临床疗效。方法 82例Hp感染患者,随机分为观察组和对照组,每组41例。观察组患者采用四联药物+气滞胃痛颗粒治疗,对照组患者仅采用四联药物治疗。观察并对比两组临床疗效以及Hp根除情况。结果观察组患者临床治疗总有效率为95.12%,对照组患者临床治疗总有效率为78.05%,观察组患者的临床治疗总有效率明显高于对照组患者,差异有统计学意义(P<0.05)。观察组患者Hp根除率为95.12%,对照组患者Hp根除率为80.49%,观察组患者Hp根除率明显高于对照组患者,差异有统计学意义(P<0.05)。结论四联药物联合气滞胃痛颗粒治疗Hp感染,能明显提高Hp感染患者的临床疗效, Hp根除率也明显提高,值得在临床工作中广泛推广。 展开更多
关键词 气滞胃痛颗粒 四联药物 幽门螺杆菌感染 临床疗效
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