Objective: To explore the clinical manifestations of pulmonary tuberculosis combined with diabetes and the impact of diabetes control on TB treatment. Methods: The clinical data of 54 patients with pulmonary tuberculosis combined with diabetes mellitus, admitted to our hospital, were retrospectively analyzed. Result: Pulmonary tuberculosis with diabetes to type 2 diabetes, mainly X-ray manifestations of tuberculosis to a large leakage, cheese lesions mainly sputum-positive rate, complications, mostly clinical features, blood glucose control in the majority of 7.8mmol/L below. Conclusion: Of pulmonary tuberculosis patients with diabetes mellitus should be an early formal anti-tuberculosis treatment, and appropriate to extend the course of treatment, while effective control of blood sugar is the key to treatment of tuberculosis with diabetes mellitus.

Objective: To observe the protective effect of Bao-gan-kang-lao decoction on acute hepatic injury.Methods: The acute hepatic injury model of mice was induced by carbon tetrachloride and anti-tuberculosis drugs Rifampacin and Isoniazid.We measured the changes of serum ALT,AST and liver index after the administration of the Bao-gan-kang-lao decoction for 6 days,and observed the acute toxicity of Bao-gan-kang-lao decoction.Results: Bao-gan-kang-lao decoction with the dose of 22 and 44 g·kg-1·d-1 could obviously reduce the levels of ALT and AST and the coefficient of liver weight induced by carbon tetrachloride and anti-tuberculosis drugs Rifampacin and Isoniazid.The maximum dosage to mice was 225 g·kg-1·d-1 155 times of human clinical dosage.Conclusions: Bao-gan-kang-lao decoction has protective effect on liver injury induced by carbon tetrachloride and anti-tuberculosis drugs Rifampacin and Isoniazid.Bao-gan-kang-lao decoction has not much toxicity,and is safe and reliable in clinic.

自20世纪90年代以来,全球结核病疫情回升.在造成全球结核病疫情升高的诸多因素中,耐多药结核病是主要原因之一.近年来据WHO估算,全球每年耐药结核病发病人数约30万至60万,实际耐多药肺结核患者数可能接近或超过100万[1],而中国的耐多药肺结核患者数占全球的1、4～1、3.遗憾的是目前全球对耐多药肺结核的发生的分子机制尚不清楚,缺乏快速的结核分枝杆菌耐药检测方法和治疗手段,使耐多药肺结核的不断产生和流行,成为当今全球亟待解决的难题之一.自从喹诺酮类药物应用于治疗肺结核后,给耐多药结核的治疗带来了新的希望.随着喹诺酮类药物在临床上的广泛应用,喹诺酮类药物的耐药情况日趋严重.现就我院近年来对结核杆菌培养后有左氧氟沙星耐药情况的菌株进行回顾性分析并将结果报告如下.

Objective To assess the efficacy and safety of rifabutin in the treatment of multidrug-resistant pulmonary tuberculosis.Methods An 18-month randomized,open and controlled study was conducted.In rifabutin group,rifabutin,pasiniazid,levofloxacin,ethambutol,protionamide and amikacin were administrated in the initial 3-month phase.In the following 6-month phase,rifabutin,pasiniazid,levofloxacin,ethambutol and protionamide were used.And then in the 9 months continuation phase,patients received rifabutin,pasiniazid,levofloxacin and ethambutol.Drug administration in control group was similar to rifabutin group,the only excepticn was that rifabutin wasreplaced by rifapentine.Results Compared with the control group,the rifabutin group showed potential for radiologically evident improvement,cavity closure and clinical improvement in all phases.The rate of radiologically evident improvement in 3-month phase and the rate of bacteriologic conversion in 6-month phase were 100%.Besides,adverse events of rifabutin were similar to other regimens of treating TB.Conclusion In the treatment of multidrug-resistant pulmonary tuberculosis,the efficacy and safety of rifabutin was superior to rifapentine,which indicated that rifabutin was a prospective drug to treat multidrug-resistant pulmonary tuberculosis.

近年耐多药肺结核患者越来越多.对耐多药肺结核的治疗,已成为国内外专家重点研究的课题.自从喹诺酮类药物应用于治疗肺结核后,给耐多药结核的治疗带来了新的希望.随着喹诺酮类药物在临床上的广泛应用,喹诺酮类药物的耐药情况日趋严重.

作者观察了重组人白细胞介素-2辅助治疗复治肺结核病的疗效,现将结果报告如下.

目前,国内外已在抗结核化疗的基础上应用免疫治疗,其中母牛分支杆菌(M.Vaccae)菌苗的研究和应用取得了进展.本文通过随机对照研究, 对M.Vaccae菌苗免疫辅助治疗,缩短初治肺结核疗程的效果进行初步观察.