结核分枝杆菌潜伏感染预防性治疗的进展

doi:10.3969/j.issn.1000-6621.2015.01.015

摘要/Abstract

摘要： 结核分枝杆菌潜伏感染（latent tuberculosis infection，LTBI）的预防性治疗在结核病防治中扮演着重要角色。使用肿瘤坏死因子拮抗剂（tumor necrosis factor antagonist, TNF antagonist）的患者、人类获得性免疫缺陷病毒（human immunodeficiency virus, HIV）感染者、活动性结核病的密切接触者等高危人群中的LTBI者接受积极的预防性治疗可以降低结核病发病率。国际上目前推荐的LTBI常规治疗方案为9个月的异烟肼治疗方案（9INH）。其他治疗方案还包括6个月的异烟肼治疗方案（6INH），4个月利福平治疗方案（4RFP），3个月利福平+异烟肼治疗方案［3（RFP+INH）］，以及3个月的利福喷丁+异烟肼治疗方案［3(Rft+INH）］等。在中国，LTBI者基数较大，尽早开展我国LTBI者预防性治疗对于控制结核病疫情有着积极意义。但中国耐药人数已是世界第一，对于预防性抗结核治疗的人群限定需更慎重，避免进一步增加耐药率。

关键词: 潜伏性结核/药物疗法, 潜伏性结核/预防和控制, 临床方案

Abstract: The prophylactic treatment of latent tuberculosis infection plays an important role in the prevention and treatment of tuberculosis. In recent years, studies have reported that HIV-infected patients, close contacts of active tuberculosis, and patients who use tumor necrosis factor antagonists should take the prophylactic treatment for latent tuberculosis infection. The currently preferred treatment is 9 months of isoniazid therapy (9INH), other regimens includes 6 months of isoniazid therapy (6INH), 4 months of rifampicin therapy (4RFP), 3 months of rifampin + isoniazid program (3（RFP+INH）), 3 months rifapentine + isoniazid program (3（Rft+INH)）. In China, due to the large number of latent tuberculosis infection, it is of great importance to launch the preventive treatment. However, the number of drug resistant patients ranked the first in the world, careful evaluation should be conducted in order to avoid the further increase in drug resistance.

Key words: Latent tuberculosis/drug therapy, Latent tuberculosis/prevention &, control, Clinical

艾静文，阮巧玲，张文宏. 结核分枝杆菌潜伏感染预防性治疗的进展[J]. 中国防痨杂志, 2015, 37(1): 80-85. doi: 10.3969/j.issn.1000-6621.2015.01.015

AI Jing-wen，RUAN Qiao-ling，ZHANG Wen-hong. Advances in the preventive treatment of latent tuberculosis infection[J]. Chinese Journal of Antituberculosis, 2015, 37(1): 80-85. doi: 10.3969/j.issn.1000-6621.2015.01.015

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