不同类型治疗方案治疗耐多药结核病效果文献分析

摘要/Abstract

摘要： 目的比较分析近10年其他国家和地区不同类型治疗方案治疗耐多药结核病的转归情况及相关影响因素,为制定适合中国大陆地区的耐多药结核病治疗策略提供参考。方法检索Medline数据库中1996—2010年发表的耐多药结核病治疗相关文章,根据摘要内容筛检后继续查找全文。根据纳入、排除标准确定最终入选的文章。结果查找到1286篇英文摘要,最终有28篇文章符合分析标准。2篇文章采用了标准方案,1篇采用经验方案,2篇采用国家规划标准短程化疗方案,23篇采用基于药敏结果的个体化治疗方案。个体化治疗方案的治疗成功率为61.2%,标准方案为52.0%和短程化疗方案为39.2%,差异有统计学意义(P<0.05)。经验治疗方案(治疗成功率64.7%)和个体化方案的治疗效果无统计学差异(P>0.05)。结论在有条件的地区应采取个体化方案治疗耐多药结核病,国家目前的标准短程化疗方案对耐多药结核病的治疗效果是不够的。

关键词: 结核, 抗多种药物性/药物疗法, 临床方案, 治疗结果

Abstract:  Methods All the MDR treatment-related articles in “Medline” database published from 1996 to 2010 were searched. s of these papers were screened to find the full text of relevant articles. Final selection of articles was determined by inclusion and exclusion criteria.  Results A total of 1286 related English abstracts were searched originally, 28 articles were enrolled based on inclusion and exclusion criteria eventually. Among which 2 articles adopted standard treatment regimen, 1 with empirical regimen, 2 with National TB Program (NTP) standard short-course treatment regimen, and 23 with individualized regimen based on drug susceptibility test. Treatment success rate with individualized regimen is 61.2%, significantly higher than standardized MDR regimen of 52% and NTP standard short-course treatment of 39.2% (P<0.05). There is no statistical difference in treatment success rate between individualized regimen and empirical-based regimen (P>0.05). Conclusion Individualized treatment regimen should be adopted in regions where conditions permit; NTP recommended standard short course treatment is not enough for MDR-TB treatment.

Key words: tuberculosis, multi drug-resistant/drug therapy, clinical protocols, treatment outcome

中图分类号:

杜建, 徐彩红, 李琦, 姜晓颖, 马艳, 高静韬, 端木宏谨, 傅瑜, 李亮. 不同类型治疗方案治疗耐多药结核病效果文献分析[J]. 中国防痨杂志, 2010, 32(8): 7-12.

Du Jian,Xu Caihong,Li Qi,Jiang Xiaoying,Ma Yan,Gao Jingtao,Duanmu Hongjin,Fu Yu,Li Liang. Literature analysis of treatment outcome of Multi-drug resistant tuberculosis with different regimens[J]. Chinese Journal of Antituberculosis, 2010, 32(8): 7-12.

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