3HP方案治疗风湿性疾病合并结核分枝杆菌潜伏感染的前瞻性研究

doi:10.19982/j.issn.1000-6621.20220238

摘要/Abstract

摘要：

目的: 评价3HP方案(异烟肼联合利福喷丁;各0.9g/次,1次/周,共12次)预防性治疗风湿性疾病合并结核分枝杆菌潜伏感染患者的安全性与完成率。方法: 采用前瞻性研究方法,纳入2019年6—12月深圳市第三人民医院就诊的38例风湿性疾病合并结核分枝杆菌潜伏感染患者,使用3HP方案预防性抗结核治疗,记录治疗过程中的不良反应和完成率,并随访2年观察活动性结核病发生情况。结果: 使用3HP方案治疗患者不良反应发生率为15.8%(6/38),其中,消化道反应者2例(5.3%),失眠、头晕、皮疹、药物性肝损伤者各1例(2.6%);药物性肝损伤者中断治疗1例,治疗完成率为97.4%(37/38);随访2年均未观察到活动性结核病发生。结论: 3HP方案预防性治疗风湿性疾病患者合并结核分枝杆菌潜伏感染的安全性好,完成率高,预防活动性结核病的效能仍有待进一步评价。

关键词: 潜伏性结核感染, 风湿性疾病, 临床方案, 治疗,临床研究性, 前瞻性研究

Abstract:

Objective: To evaluate the safety and completion rate of 3HP regimen (isoniazid plus rifapentine; Each 0.9 g/time, once a week, 12 times) in the treatment of rheumatic diseases complicated with Mycobacterium tuberculosis latent infection (LTBI). Methods: Using a prospective study approach,38 patients with rheumatic disease complicated by LTBI,were prospectively enrolled from June to December 2019 in the Third People’s Hospital of Shenzhen. 3HP regimen was used for preventive therapy and completion rate, adverse events were recorded. All participants were followed up for 2 years of active tuberculosis. Results: The incidence of adverse events in patients treated with 3HP regimen was 15.8% (6/38), including 2 cases (5.3%) of gastrointestinal reactions, 1 case (2.6%) of insomnia, dizziness, rash and drug-induced hepatitis respectively. One participant ceased tuberculosis preventive therapy due to drug-induced hepatitis. The completion rate was 97.4% (37/38). No active tuberculosis was observed during 2 years of follow-up. Conclusion: 3HP regimen has good safety and high completion rate in the prophylactic treatment of patients with rheumatic diseases complicated with LTBI. The efficacy of 3HP regimen in the prevention of active tuberculosis still needs to be further evaluated.

Key words: Mycobacterium tuberculosis latent infection, Rheumatic diseases, Clinical protocols, Therapies,investigational, Prospective studies

中图分类号:

R4
R521

王玉香, 陈秋奇, 余鑫鑫, 詹森林, 张培泽, 邓国防. 3HP方案治疗风湿性疾病合并结核分枝杆菌潜伏感染的前瞻性研究[J]. 中国防痨杂志, 2022, 44(9): 906-910. doi: 10.19982/j.issn.1000-6621.20220238

Wang Yuxiang, Chen Qiuqi, Yu Xinxin, Zhan Senlin, Zhang Peize, Deng Guofang. 3HP regimen in the treatment of rheumatic diseases complicated with Mycobacterium tuberculosis latent infection:a prospective study[J]. Chinese Journal of Antituberculosis, 2022, 44(9): 906-910. doi: 10.19982/j.issn.1000-6621.20220238

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