中国防痨杂志 ›› 2021, Vol. 43 ›› Issue (4): 313-317.doi: 10.3969/j.issn.1000-6621.2021.04.003
收稿日期:
2021-02-26
出版日期:
2021-04-10
发布日期:
2021-04-09
通信作者:
高微微
E-mail:gwwjys@sina.com
基金资助:
Received:
2021-02-26
Online:
2021-04-10
Published:
2021-04-09
Contact:
GAO Wei-wei
E-mail:gwwjys@sina.com
摘要:
及时合理的抗结核治疗是有效治愈结核病患者、消除传染性和阻断疾病传播的关键措施。复治标准化治疗方案的实施曾对提高复治肺结核患者治疗成功率起到显著效果。但结核分枝杆菌在不断演变和进化,患者的个体情况也在不断变化,加之当前抗结核药物治疗效果欠佳的现状,原来的复治标准化治疗方案应考虑进行相应调整及更新。笔者就目前复治肺结核治疗对象、治疗方案演变及其合理应用等结合文献和临床经验进行论述。
马艳, 高微微. 今非昔比:重视复治肺结核的合理施治[J]. 中国防痨杂志, 2021, 43(4): 313-317. doi: 10.3969/j.issn.1000-6621.2021.04.003
MA Yan*, GAO Wei-wei. Pay attention to the reasonable treatment of retreatment tuberculosis:today is not what it used to be[J]. Chinese Journal of Antituberculosis, 2021, 43(4): 313-317. doi: 10.3969/j.issn.1000-6621.2021.04.003
[1] | 中华人民共和国卫生部疾病预防控制局, 中华人民共和国卫生部医政司, 中国疾病预防控制中心. 中国结核病防治规划实施工作指南(2008年版). 北京: 中国协和医科大学出版社, 2009: 52-70. |
[2] | World Health Organization. Global Tuberculosis Report 2019. Geneva: World Health Organization, 2019. |
[3] |
Jones-López EC, Ayakaka I, Levin J, et al. Effectiveness of the standard WHO recommended retreatment regimen (category Ⅱ) for tuberculosis in Kampala, Uganda: a prospective cohort study. PLoS Med, 2011,8(3):e1000427. doi: 10.1371/journal.pmed.1000427.
doi: 10.1371/journal.pmed.1000427 URL pmid: 21423586 |
[4] |
Caminero JA. Management of multidrug-resistant tuberculosis and patients in retreatment. Eur Respir J, 2005,25:928-936. doi: 10.1183/09031936.05.00103004.
doi: 10.1183/09031936.05.00103004 URL pmid: 15863653 |
[5] | World Health Organization Regional Office for Europe. Treatment of tuberculosis. 3rd ed. Geneva: World Health Organization, 2003. |
[6] |
Nakanwagi-Mukwaya A, Reid AJ, Fujiwara PI, et al. Characteristics and treatment outcomes of tuberculosis retreatment cases in three regional hospitals, Uganda. Public Health Action, 2013,3(2):149-155. doi: 10.5588/pha.12.0105.
doi: 10.5588/pha.12.0105 URL pmid: 26393019 |
[7] |
Ottmani SE, Zignol M, Bencheikh N, et al. Results of cohort analysis by category of tuberculosis retreatment cases in Morocco from 1996 to 2003. Int J Tuberc Lung Dis, 2006,10(12):1367-1372.
URL pmid: 17167954 |
[8] |
Tabarsi P, Chitsaz E, Tabatabaei V, et al. Revised category Ⅱ regimen as an alternative strategy for retreatment of category Ⅰ regimen failure and irregular treatment cases. Am J Ther, 2011,18(5):343-349. doi: 10.1097/MJT.0b013e3181dd60ec.
doi: 10.1097/MJT.0b013e3181dd60ec URL pmid: 20535008 |
[9] |
Acuña-Villaorduña C, Ayakaka I, Dryden-Peterson S, et al. High mortality associated with retreatment of tuberculosis in a clinic in Kampala, Uganda: a retrospective study. Am J Trop Med Hyg, 2015,93(1):73-75. doi: 10.4269/ajtmh.14-0810.
doi: 10.4269/ajtmh.14-0810 URL pmid: 25940196 |
[10] | 符彩云, 符致顺. 1500例复治涂阳肺结核成因及疗效分析. 中国防痨杂志, 2000,22(2):91-92. |
[11] | 全国肺结核短化协作组. 肺结核短程化疗的研究. 中华结核和呼吸系疾病杂志, 1982,5(2):78-81. |
[12] | 全国肺结核短化协作组. 第二批肺结核短程化疗研究初报. 中华结核和呼吸系疾病杂志, 1984,7(4):198-202. |
[13] | 唐神结, 李亮. 临床医务人员结核病防治培训教材. 北京: 人民卫生出版社, 2019:27. |
[14] | 万利亚, 武桂英, 龚幼龙, 等. 结核病管理策略对复治原因的影响研究. 中国防痨杂志, 2003,25(6):347-350. |
[15] | 中华人民共和国卫生部. 全国结核病耐药基线调查报告(2007—2008年). 北京: 人民卫生出版社, 2010:49. |
[16] | 中国防痨协会. 耐药结核病化学治疗指南(2019年简版). 中国防痨杂志, 2019,41(10):1025-1073. doi: 10.3969/j.issn.1000-6621.2019.10.001. |
[17] | World Health Organization. WHO consolidated guidelines on drug-resistant tuberculosis treatment. Geneva: World Health Organization, 2019. |
[18] | World Health Organization Regional Office for Europe. WHO Treatment Guidelines for Drug-Resistant Tuberculosis, 2016 Update. Geneva: World Health Organization, 2016. |
[19] | World Health Organization Regional Office for Europe. Guidelines for treatment of drugsusceptible tuberculosis and patient care. Geneva: World Health Organization, 2017. |
[20] | 朱莉贞, 高孟秋, 陈巍, 等. 复治肺结核化疗新方案与原复治方案的临床对照研究. 中国防痨杂志, 2012,34(5):304-309. |
[21] |
Zhou C, Jiang W, Yuan L, et al. Access to Bacteriologic-Based Diagnosis in Smear Positive Retreatment Tuberculosis Patients in Rural China: A Cross-Sectional Study in Three Geographic Varied Provinces. PLoS One, 2016,11(1):e0146340. doi: 10.1371/journal.pone.0146340.
doi: 10.1371/journal.pone.0146340 URL pmid: 26751583 |
[22] |
Wang XM, Yin SH, Du J, et al. Risk factors for the treatment outcome of retreated pulmonary tuberculosis patients in China: an optimized prediction model. Epidemiol Infect, 2017,145(9):1805-1814. doi: 10.1017/S0950268817000656.
doi: 10.1017/S0950268817000656 URL pmid: 28397611 |
[23] | 杨新宇, 易俊莉, 邢青, 等. 881例疑似耐多药肺结核患者的耐药性分析. 中国防痨杂志, 2018,40(2):183-188. doi: 10.3969/j.issn.1000-6621.2018.02.014. |
[24] | 杨安文, 周亮, 徐祖辉, 等. 湖南省肺结核四种一线抗结核药物耐药特征及影响因素研究. 中国人兽共患病学报, 2018,34(5):396-403. doi: 10.3969/j.issn.1002-2694.2018.00.074. |
[25] |
Abdella K, Abdissa K, Kebede W, et al. Drug resistance patterns of Mycobacterium tuberculosis complex and associated factors among retreatment cases around Jimma, Southwest Ethiopia. BMC Public Health, 2015,15:599. doi: 10.1186/s12889-015-1955-3.
doi: 10.1186/s12889-015-1955-3 URL pmid: 26135909 |
[26] | 杜建, 高微微, 马艳, 等. 优化方案和规范化方案对复治肺结核合并糖尿病的疗效. 中华结核和呼吸杂志, 2015,38(12):886-891. doi: 10.3760/cma.j.issn.1001-0939.2015.12.003. |
[27] | 沙巍, 张青, 崔文玉, 等. 首次复治肺结核患者短程化疗新方案的临床研究. 中国防痨杂志, 2017,39(1):39-45. doi: 10.3969/j.issn.1000-6621.2017.01.011. |
[28] | 杜建, 刘宇红, 李亮, 等. 复治肺结核患者采用不同化疗方案的效果评价. 中国防痨杂志, 2016,38(10):850-857. doi: 10.3969/j.issn.1000-6621.2016.10.013. |
[29] |
Sander MS, Vuchas CY, Numfor HN, et al. Sputum bacterial load predicts multidrug-resistant tuberculosis in retreatment patients: a case-control study. Int J Tuberc Lung Dis, 2016,20(6):793-799. doi: 10.5588/ijtld.15.0259.
doi: 10.5588/ijtld.15.0259 URL pmid: 27155183 |
[30] |
Akhtar AM, Arif MA, Kanwal S, et al. Prevalence and drug resistance pattern of MDR TB in retreatment cases of Punjab, Pakistan. J Pak Med Assoc, 2016,66(8):989-993.
URL pmid: 27524534 |
[31] |
Cohen DB, Meghji J, Squire SB. A systematic review of clinical outcomes on the WHO Category Ⅱ retreatment regimen for tuberculosis. Int J Tuberc Lung Dis, 2018,22(10):1127-1134. doi: 10.5588/ijtld.17.0705.
URL pmid: 30236179 |
[32] | 巫株华, 黎贞燕, 李宇轩, 等. 广东省2911例涂阳肺结核病患者的耐药疫情分析. 广东医学, 2018,39(2):228-234. doi: 10.3969/j.issn.1001-9448.2018.02.016. |
[33] |
Li Q, Zhao G, Wu L, et al. Prevalence and patterns of drug resistance among pulmonary tuberculosis patients in Hangzhou, China. Antimicrob Resist Infect Control, 2018,7:61. doi: 10.1186/s13756-018-0348-7.
doi: 10.1186/s13756-018-0348-7 URL pmid: 29744042 |
[34] | 戈启萍, 杜建, 姜广路, 等. 标准复治化疗方案治疗多耐药及敏感复治肺结核患者的对比研究. 中国防痨杂志, 2015,37(8):879-884. doi: 10.3969/j.issn.1000-6621.2015.08.017. |
[35] |
Lee H, Ahn S, Hwang NY, et al. Limited effect of later-generation fluoroquinolones in the treatment of ofloxacin-resistant and moxifloxacin-susceptible multidrug-resistant tuberculosis. Antimicrob Agents Chemother, 2018,62(2):e01784-17. doi: 10.1128/AAC.01784-17.
doi: 10.1128/AAC.01784-17 URL pmid: 29203478 |
[36] |
Ndjeka N, Schnippel K, Master I, et al. High treatment success rate for multidrug-resistant and extensively drug-resistant tuberculosis using a bedaquiline-containing treatment regimen. Eur Respir J, 2018,52(6):1801528. doi: 10.1183/13993003.01528-2018.
doi: 10.1183/13993003.01528-2018 URL pmid: 30361246 |
[37] | 杜建, 韩喜琴, 舒薇, 等. 复治菌阳肺结核患者治疗成功后再次复发的危险因素分析. 中国防痨杂志, 2019,41(6):624-631. doi: 10.3969/j.issn.1000-6621.2019.06.007. |
[38] |
Velayati AA, Farnia P, Ibrahim TA, et al. Differences in cell wall thickness between resistant and nonresistant strains of Mycobacterium tuberculosis: using transmission electron microscopy. Chemotherapy, 2009,55(5):303-307. doi: 10.1159/000226425.
doi: 10.1159/000226425 URL pmid: 19556787 |
[39] |
Parwati I, van Crevel R, van Soolingen D. Possible underlying mechanisms for successful emergence of the Mycobacterium tuberculosis Beijing genotype strains. Lancet Infect Dis, 2010,10(2):103-111. doi: 10.1016/S1473-3099(09)70330-5.
URL pmid: 20113979 |
[40] | 中国防痨协会. 耐药结核病化学治疗指南(2015). 中国防痨杂志, 2015,37(5):421-469. doi: 10.3969/j.issn.1000-6621.2015.05.001. |
[41] | World Health Organization Regional Office for Europe. Rapid communication: key changes to treatment of multidrug- and rifampicin-resistant tuberculosis (MDR/RR-TB). Geneva: World Health Organization, 2018 |
[42] | World Health Organization Regional Office for Europe. WHO treatment guidelines for isoniazid-resistant tuberculosis: Supplement to WHO treatment guidelines for drug-resistant tuberculosis. Geneva: World Health Organization, 2018. |
[43] | 黄学锐, 高微微, 张旭霞, 等. 氧氟沙星和左氧氟沙星抗结核分枝杆菌临床耐药界限的研究. 中华结核和呼吸杂志, 2004,27(2):84-88. |
[44] | 张旭霞, 王苏民, 高微微. 三种喹诺酮类药物抗结核分支杆菌最低抑菌浓度分布状况研究. 中国防痨杂志, 2001,23(4):222-224. |
[45] |
Silva TC, Matsuoka PDFS, Aquino DMC, et al. Factors associated with tuberculosis retreatment in priority districts of Maranhão, Brazil. Cien Saude Colet, 2017,22(12):4095-4104. doi: 10.1590/1413-812320172212.20612015.
doi: 10.1590/1413-812320172212.20612015 URL pmid: 29267726 |
[46] |
Zheng C, Li S, Luo Z, et al. Mixed Infections and Rifampin Heteroresistance among Mycobacterium tuberculosis Clinical Isolates. J Clin Microbiol, 2015,53(7):2138-2147. doi: 10.1128/JCM.03507-14.
doi: 10.1128/JCM.03507-14 URL pmid: 25903578 |
[47] | 陈燕琴, 杜建, 刘宇红, 等. 住院肺结核患者体重与口服异烟肼剂量的关系. 中华结核和呼吸杂志, 2018,41(7):529-533. doi: 10.3760/cma.j.issn.1001-0939.2018.07.005. |
[48] | Chen L, Du J, Li L, et al. Low doses of rifampicin used in new tuberculosis patients correlated to increased frequency of rifampicin-resistance and poorer treatment outcomes. Open Journal of Medical Microbiology, 2015,5(2):76-84. doi: 10.4236/ojmm.2015.52009. |
[49] | 杜建, 钟球, 傅衍勇, 等. 复治肺结核患者初治时使用利福类药物剂量的调查. 中国防痨杂志, 2016,38(1):42-46. doi: 10.3969/j.issn.1000-6621.2016.01.010. |
[50] |
Prahl JB, Johansen IS, Cohen AS, et al. Clinical significance of 2 h plasma concentrations of first-line anti-tuberculosis drugs: a prospective observational study. J Antimicrob Chemother, 2015,70(1):321-322. doi: 10.1093/jac/dku373.
doi: 10.1093/jac/dku373 URL pmid: 25246439 |
[51] | 孙晓方, 严文, 任裴, 等. 442例异烟肼血药浓度监测结果分析. 中国防痨杂志, 2015,37(11):1136-1140. doi: 10.3969/j.issn.1000-6621.2015.11.011. |
[52] | 魏香兰, 方如塘, 师延峰, 等. 抗结核药物的血药浓度监测结果分析. 中国医院药学杂志, 2015,35(21):1918-1921. doi: 10.13286/j.cnki.chinhosppharmacyj.2015.21.08. |
[1] | 中国防痨协会结核病控制专业分会, 中国防痨协会青年分会, 《中国防痨杂志》编辑委员会. 中国结核病数字服药依从性技术应用指南[J]. 中国防痨杂志, 2025, 47(4): 385-397. |
[2] | 李锦浩, 胡冬梅, 徐彩红. 结核病防治医务工作者开展预防性抗结核治疗工作意愿调查及影响因素分析[J]. 中国防痨杂志, 2025, 47(4): 398-407. |
[3] | 李玉红, 梅金周, 苏伟, 阮云洲, 刘玉舒, 赵雁林, 刘小秋. 2015—2021年全国65岁及以上老年利福平耐药肺结核患者治疗转归及影响因素分析[J]. 中国防痨杂志, 2025, 47(4): 408-415. |
[4] | 姜雪, 白云龙, 马建军, 安源, 杨帆, 赵庆龙. 2020—2023年吉林省利福平耐药肺结核患者诊治延迟现状及影响因素分析[J]. 中国防痨杂志, 2025, 47(4): 416-424. |
[5] | 吴璇, 张艳秋, 徐吉英, 孟丹, 孙定勇. 2019—2023年河南省肺结核合并糖尿病患者治疗转归影响因素分析[J]. 中国防痨杂志, 2025, 47(4): 425-431. |
[6] | 安源, 白云龙, 赵庆龙, 马建军, 姜雪, 潘艳, 高迎, 高智慧. 2018—2022年吉林省肺结核合并糖尿病患者治疗转归情况及影响因素分析[J]. 中国防痨杂志, 2025, 47(4): 432-438. |
[7] | 冯畏, 郑海伦, 孟炜丽, 罗萍. 2018—2023年北京市西城区结核病防治机构登记管理肺结核患者到位前漏报情况分析[J]. 中国防痨杂志, 2025, 47(4): 439-443. |
[8] | 胡一凡, 杜博平, 吴亚东, 朱传智, 张蓝月, 贾红彦, 孙琦, 潘丽萍, 张宗德, 李自慧. Mce4C蛋白参与结核分枝杆菌摄取利用胆固醇的实验研究[J]. 中国防痨杂志, 2025, 47(4): 444-453. |
[9] | 盛杰, 洪凯峰, 米尔扎提·艾沙, 唐伟, 地里下提·阿不力孜. 白细胞介素22和p38 MAPK信号通路抑制骨关节结核骨质破坏的作用机制研究[J]. 中国防痨杂志, 2025, 47(4): 454-459. |
[10] | 王颖超, 刘唯夷, 姬秀秀, 尚雪恬, 贾红彦, 张蓝月, 孙琦, 杜博平, 朱传智, 潘丽萍, 张宗德. 结核病患者外周血单个核细胞内环状RNA表达谱分析及诊断标识的鉴定[J]. 中国防痨杂志, 2025, 47(4): 460-470. |
[11] | 朱明智, 邵燕琴, 范大鹏, 刘立宾, 梅宾, 戴玲珊, 蔡龙. 尿液脂阿拉伯甘露聚糖抗原检测对肺外结核的诊断价值[J]. 中国防痨杂志, 2025, 47(4): 471-476. |
[12] | 郝明晓, 米洁, 许宗仪. 延续性护理路径在结核性脑膜炎患者中的应用效果分析[J]. 中国防痨杂志, 2025, 47(4): 477-481. |
[13] | 尚希钰, 张慧芳, 曹玉清, 熊一白, 纪鑫毓, 田雅欣, 李佳佳, 王倪, 马艳. 基于文献计量学的结核病中医药基础研究全球研究现状及热点分析[J]. 中国防痨杂志, 2025, 47(4): 482-497. |
[14] | 秦丽莉, 杨澄清, 麦洪珍, 徐齐峰, 薛新颖, 路希维. 结核后肺曲霉病的临床诊疗研究进展[J]. 中国防痨杂志, 2025, 47(4): 498-504. |
[15] | 罗莉, 罗林紫, 尹曲华, 周磊, 卢志斌, 丁衍, 肖阳宝. 淋巴结瘘型气管支气管结核的支气管镜下诊疗进展[J]. 中国防痨杂志, 2025, 47(4): 505-512. |
阅读次数 | ||||||
全文 |
|
|||||
摘要 |
|
|||||