目的探讨抗结核药物对乙肝病毒标志物阳性肺结核患者肝功能影响及防治对策。方法回顾性分析1276例初治肺结核患者及其中100例药物性肝损害的临床资料。结果 136例乙型肝炎病毒标志物(HBVM)阳性肺结核患者中有54例(39.7%)出现肝损害,HBVM阴性患者1140例中出现肝损害46例(4.0%),两组比较差异有统计学意义(P<0.01)。抗结核治疗后出现肝损害的时间分别为(18.7±11.3)d、(31.5±13.2)d。肝损害的程度ALT分别为(121.1±55.2)U/L、(75.4±32.3)U/L;TBIL分别为(57.0±33.2)μmol/L、(36.8±24.9)μmol/L。两组比较均有统计学意义(P<0.05)。结论抗结核药物对乙肝病毒标志物阳性肺结核患者有一定影响,在抗结核治疗前检查HBVM及肝功能十分必要,对HBVM阳性的患者在抗结核治疗中应密切监测肝功能情况,一旦出现肝损害,应根据肝损害的程度选择适当的抗结核治疗及护肝治疗。
合并糖尿病肺结核临床上较为常见,肺结核与糖尿病互有不利影响.本文对合并糖尿病的初治菌阳肺结核患者的临床治疗效果进行观察,现报告如下.
为减少不典型肺结核的误诊,本文对1998-2000年误诊的14岁以上39例肺结核进行回顾性分析.1 临床资料1.1 选例标准 1998-2000年经临床证实为肺结核的14岁以上病人,而在本所及外院误诊超过15 d者,共39例.男23例,女16例,年龄15~78岁,平均年龄50.1岁.15~20岁3例;21~30岁4例;31~40岁6例;41~50岁7例;51~60岁8例;61~78岁11例(28.2%).误诊时间16 d~24个月.
为减少不典型肺结核的过诊、漏诊与误诊.提高不典型肺结核的临床诊断水平.本文对1998~2000年误诊的14岁以上39例肺结核进行回顾性分析.
Objective To understand the therapeutic effects of containing DPC or PAS regimens on MDR-pulmonary tuberculosis.Methods 39 cases of MDR-pulm.tuberculosis are selected and divided randomly in DPC group and P group respectively.Results After complete the treatment course,the sputum negative conversion rate of above two groups was 95% and 93% respectively.The X-Ray resolving rate were 86% equally.The relapse rate following 2 years follow-up were 5% and 8%.All above results of two groups were no significant difference(P>0.05),but the occurence rate of gastrointestinal adverse reaction and phlebitis of group DPC was much lower than those of the P group(P<0.05).Conclusion The antituberculosis regimen of DPC or PAS with K、O、TH and Z reparatively is an effective and safe approach for treating the multi-drug resistant pulm.tuberculosis,especially the 2 KOTHZ DPC/6-10 OTHZ DPC regimen is cheap cost,less adverse reaction and easy to accept,therefore it is worth recommending.
目的探讨结核病治愈后抗结核抗体在体内持续的时间.方法 ELISA法以PPD为包被抗原,每隔3个月检测治愈时血清抗结核抗体呈阳性的肺结核病人血清抗结核抗体1次,连续18个月.结果每隔3个月抗结核抗体阳性人数逐渐下降,12个月时下降最明显,从9个月时的109人(63.0%)下降到21人(12.1%),与健康对照组间差异显著(P<0.05);15个月时阳性人数11人(6.4%),与健康对照组间差异不显著(P>0.05).结论肺结核病治愈后抗结核抗体呈阳性的病人其特异性抗体阳性持续时间一般为12~15个月,Ⅳ型结核治疗前病灶范围广,治愈后以增殖性病灶为主的患者持续的时间较长.