关键词: 结核, 肺/药物疗法, 利福布丁, 利福平, 临床方案

Abstract: Objective To learn the therapeutic effect of rifabutin on retreatment smearpositive pulmonary tuberculosis. Methods This was a prospective cohort study. One hundred and twenty retreatment pulmonary tuberculosis（PTB）inpatients registered from September 15, 2009 to June 30, 2010 in Shangqiu Research Institute for Tuberculosis Control and Prevention were selected and divided into 2 groups randomly. One group（60 cases）were treated with the regimen 2HBZES/6HBE（B:rifabutin）,and the other group（60 cases）were treated with the regimen 2HRZES/6HRE. The sputum conversion rates,changes of lesion absorption and cavity closure rates were compared between the two groups. SPSS 13.0 software was used for data sorting and analysis.Chi-square test was applied for comparison. A Pvalue of 0.05 was used to signify statistical significance. Results At the end of 2 months of treatment,the sputum conversion rate was 48.33%（29/60）for rifabutin group and 30.0%（18/60）for rifampicin group,and the difference was statistical significant（χ²=4.23，P<0.05）. According to the results of chest X-ray,the efficiency rate of rifabutin group（21.67%（13/60））was significantly higher than rifampicin group 8.33%（5/60）（χ²=4.18，P<0.05）,and the effective rates were 36.67%（22/60）and 18.33%（11/60）respectively,with significant difference（χ²=5.06，P<0.05）. The sputum conversion rates at the end of treatment in the 2 groups were 81.67%（49/60）and 61.67%（37/60）respectively,and the difference was significant（χ²=5.91，P<0.05）. The radiographic outcomes showed that the cavity closure rate of Rifabutin group 47.92%（23/48））was significantly higher than rifampicin group（27.45%（14/51））（χ²=4.43，P<0.05）. For the changes of lesion absorption,the efficiency rates were 53.33%（32/60）and 35.00%（21/60）,respectively,with significant difference（χ²=4.09，P<0.05）. The effective rate of rifabutin group（68.33%（41/60））was significantly higher than rifampicin group（48.33%（29/60））（χ²=4.94，P<0.05）. Conclusion The regimen with rifabutin has better clinical therapeutic effect on retreatment pulmonary tuberculosis.

Key words: Tuberculosis, pulmonary/drug therapy, Rifabutin, Rifampin, Clinical protocols