Drug susceptibility testing (DST) plays a pivotal role in TB patients’ management leading to the selection of most effective drugs. This study aimed to determine resistance patterns to first line anti-TB drugs in Myc...Drug susceptibility testing (DST) plays a pivotal role in TB patients’ management leading to the selection of most effective drugs. This study aimed to determine resistance patterns to first line anti-TB drugs in Mycobacterium tuberculosis isolates from re-treated patients from Sudan. A total of 239 sputum specimens were collected from smear positive re-treatment TB patients during the period from July 2009 to July 2010. Specimens were pre-treated according to Petroff method. The recovered isolates were tested for sensitivity to first line anti-TB drugs by the 1% proportion method. One hundred and forty three (143/239, 59.8%) mycobacterial isolates were successfully recovered. The majority (98.6%, 141/143) of the isolates were Mycobacterium tuberculosis complex strains. Two strains (2/143, 1.4%) were identified as RIF/INH-resistant MOTT, while fifty four isolates (38.3%, 54/141) were MDR. Multi- drug resistant Mycobacterium tuberculosis complex (MDR-TB) among re-treatment patients from national referral centers for tuberculosis diagnosis and management was considerably high in the study isolates.展开更多
目的观察应用丙酚替诺福韦(TAF)继续治疗经恩替卡韦(ETV)治疗的低病毒血症(LLV)的慢性乙型肝炎(CHB)患者的疗效。方法2018年1月~2022年12月我院收治的CHB患者101例,纳入患者均接受ETV治疗至少48周,经检测符合LLV定义标准,被随机分为两组...目的观察应用丙酚替诺福韦(TAF)继续治疗经恩替卡韦(ETV)治疗的低病毒血症(LLV)的慢性乙型肝炎(CHB)患者的疗效。方法2018年1月~2022年12月我院收治的CHB患者101例,纳入患者均接受ETV治疗至少48周,经检测符合LLV定义标准,被随机分为两组,其中50例继续应用ETV治疗48周,另51例换用TAF治疗48周。常规检测血清肌酐(sCr)、β_(2)微球蛋白(β_(2)-MG)和估算的肾小球滤过率(eGFR),完全病毒学应答率(CVR)定义为血清HBV DNA载量<20 IU/mL。使用瞬时弹性成像探测仪行肝脏硬度检测(LSM)。结果在治疗48周末,TAF治疗组CVR为98.0%,显著高于ETV治疗组的24.0%(P<0.05),而两组血清HBeAg转阴率(17.7%对4.0%,P>0.05)和ALT复常率(96.1%对98.0,P>0.05)无显著性差异;TAF治疗组血清ALT、AST水平和LSM分别为(37.7±5.3)U/L、(34.8±5.7)U/L和(7.1±1.0)kPa,与ETV治疗组【分别为(36.2±4.8)U/L、(35.2±5.3)U/L和(7.8±1.1)kPa,P>0.05】比,无显著性差异;TAF组sCr和血清β_(2)-MG水平分别为(70.4±6.5)μmol/L和(1.3±0.3)mg/L,显著低于ETV治疗组【分别为(78.5±6.9)μmol/L和(1.6±0.2)mg/L,P<0.05】,而eGFR为(105.9±17.3)mL/min/1.73 m 2,显著高于ETV治疗组【(98.0±16.7)mL/min/1.73 m 2,P<0.05】。结论对于ETV经治后出现LLV的CHB患者转换为TAF继续治疗可提高病毒学应答率,安全性高,值得继续扩大验证。展开更多
文摘Drug susceptibility testing (DST) plays a pivotal role in TB patients’ management leading to the selection of most effective drugs. This study aimed to determine resistance patterns to first line anti-TB drugs in Mycobacterium tuberculosis isolates from re-treated patients from Sudan. A total of 239 sputum specimens were collected from smear positive re-treatment TB patients during the period from July 2009 to July 2010. Specimens were pre-treated according to Petroff method. The recovered isolates were tested for sensitivity to first line anti-TB drugs by the 1% proportion method. One hundred and forty three (143/239, 59.8%) mycobacterial isolates were successfully recovered. The majority (98.6%, 141/143) of the isolates were Mycobacterium tuberculosis complex strains. Two strains (2/143, 1.4%) were identified as RIF/INH-resistant MOTT, while fifty four isolates (38.3%, 54/141) were MDR. Multi- drug resistant Mycobacterium tuberculosis complex (MDR-TB) among re-treatment patients from national referral centers for tuberculosis diagnosis and management was considerably high in the study isolates.
文摘目的观察应用丙酚替诺福韦(TAF)继续治疗经恩替卡韦(ETV)治疗的低病毒血症(LLV)的慢性乙型肝炎(CHB)患者的疗效。方法2018年1月~2022年12月我院收治的CHB患者101例,纳入患者均接受ETV治疗至少48周,经检测符合LLV定义标准,被随机分为两组,其中50例继续应用ETV治疗48周,另51例换用TAF治疗48周。常规检测血清肌酐(sCr)、β_(2)微球蛋白(β_(2)-MG)和估算的肾小球滤过率(eGFR),完全病毒学应答率(CVR)定义为血清HBV DNA载量<20 IU/mL。使用瞬时弹性成像探测仪行肝脏硬度检测(LSM)。结果在治疗48周末,TAF治疗组CVR为98.0%,显著高于ETV治疗组的24.0%(P<0.05),而两组血清HBeAg转阴率(17.7%对4.0%,P>0.05)和ALT复常率(96.1%对98.0,P>0.05)无显著性差异;TAF治疗组血清ALT、AST水平和LSM分别为(37.7±5.3)U/L、(34.8±5.7)U/L和(7.1±1.0)kPa,与ETV治疗组【分别为(36.2±4.8)U/L、(35.2±5.3)U/L和(7.8±1.1)kPa,P>0.05】比,无显著性差异;TAF组sCr和血清β_(2)-MG水平分别为(70.4±6.5)μmol/L和(1.3±0.3)mg/L,显著低于ETV治疗组【分别为(78.5±6.9)μmol/L和(1.6±0.2)mg/L,P<0.05】,而eGFR为(105.9±17.3)mL/min/1.73 m 2,显著高于ETV治疗组【(98.0±16.7)mL/min/1.73 m 2,P<0.05】。结论对于ETV经治后出现LLV的CHB患者转换为TAF继续治疗可提高病毒学应答率,安全性高,值得继续扩大验证。
文摘目的 比较内镜下套扎治疗与内镜下组织胶注射用于肝硬化胃静脉曲张出血二级预防的疗效及安全性。方法 选择2017年1月至2019年12月因肝硬化胃静脉曲张出血入住复旦大学附属中山医院,行食管胃曲张静脉内镜下套扎治疗的患者(套扎组),另选择同期行内镜下组织胶注射治疗的患者(组织胶组),通过倾向性评分匹配,两组分别纳入59例。采用单因素与多因素Cox比例风险回归模型分析食管胃静脉曲张再出血影响因素。绘制Kaplan-Meier曲线,比较两组患者再出血及生存情况。结果 套扎组与组织胶组患者食管胃静脉曲张根除率差异无统计学意义(83.05%vs 79.66%,P=0.778);套扎组根除静脉曲张所须中位内镜治疗次数(2 vs 3次,P=0.017)及平均组织胶用量明显少于组织胶组(0.70 mL vs 2.67 mL,P<0.001)。多因素Cox回归分析显示,门体分流是食管胃静脉曲张再出血的危险因素(HR=3.14,95%CI 1.02~9.68,P=0.046),内镜下套扎是预防再出血的保护因素(HR=0.25,95%CI 0.08~0.71,P=0.010)。相较于内镜下组织胶注射,内镜下套扎不增加患者2年食管胃静脉曲张再出血风险(18.69%vs 36.29%,P=0.067)与死亡风险(1.69%vs 3.39%,P=1.000)。相较于内镜下组织胶注射,经内镜下套扎治疗后,GOV1型患者食管胃静脉曲张再出血风险较低(0 vs 40.27%,P=0.012),GOV2型患者再出血风险(13.27%vs 34.16%,P=0.056)呈降低趋势。结论 内镜下套扎治疗对食管胃静脉曲张的根除率较高,且并不增加再出血、死亡等事件风险,可作为胃静脉曲张出血患者的二级预防手段。
