【摘要】 目的观察利福喷汀对老年肺结核的有效性及安全性。方法选取老年初治涂阳肺结核患者129例,分为治疗组(2HL2ZE/4HL2)、对照组(2HRZE/4HR),观察痰菌阴转率、X线好转率、1年复发率及药物不良反应。结果治疗组3个月、疗程结束痰菌阴转率分别为87.1%、98.4%,对照组分别为85.2%、96.3%,2组疗效比较差异无统计学意义(χ21=0.09,χ22=0.02,P>0.05);X线有效率分别为了90.3%、87.0%、(P>0.05);空洞闭合率分别为36.7%、32.6%(P>0.05);1年随访痰菌复发率分别为6.4%、7.4%(P>0.05)。在不良反应方面,治疗组和对照组胃肠道反应分别为19.4%、38.9%,两组差异有统计学意义(χ2=5.41P<0.05),肝功能损害分别为4.8%、24.1%,两组差异有统计学意义(χ2=7.44P<0.01)。结论利福喷汀替代利福平治疗老年初治涂阳肺结核取得满意疗效,不良反应少,值得临床应用。更多还原

【Abstract】 Objective To observe the efficacy and safety of Rifapentine to patients with new smear-positive pulmonary tuberculosis.Methods129 elderly patients with new smear-positive pulmonary tuberculosis were enrolled and randomized into the treatment group(2HL2ZE/4HL2) and the control group(2HRZE/4HR).We observed the sputum negative conversion rate,chest X-ray improvement rate,one-year relapse rate and the side effects of anti-tuberculosis drugs.ResultsThe sputum negative conversion rates in the treatment group were 87.19% at 3 months,and 98.4% at the end of therapeutic course,while those of the control group were 85.2% and 96.3% respectively.The difference in the sputum negative conversion rates between the two groups were not statistically significant(χ21=0.09,χ22=0.02,P>0.05).The improvement rates of chest X-ray were 90.3% and 87.0% respectively without significant difference(P>0.05).The cavity closure rate were 36.7% in the treatment group,and 32.6% in the control group without statistical difference between two groups(P>0.05).One-year bacteriological relapse rate were 6.4% and 7.4% respectively without significant difference(P>0.05).The gastroinsterstinal reaction rate were 19.4% in the treatment group and 38.9% in the control group with statistically significant difference(χ2=5.41 P<0.05),and the rate of liver function damage were 4.8% in the treatment group and 24.1% in control group with statistically significant difference(χ2=7.44 P<0.01).ConclusionsThe treatment efficacy of regimen including Rifapentine was the same as that of regimen including Rifampin to elderly patients with new smear-positive pulmonary tuberculosis.The side effects rate of Rifapentine was very lower than that of Rifampin.It could be recommended to use widely further.更多还原