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中国防痨杂志 ›› 2003, Vol. 25 ›› Issue (6): 343-346.

• 论著 • 上一篇    下一篇

北京农村全面监督短程化疗(DOTS)下初治涂阳肺结核病人五年转归的研究

李波1;屠德华1;梁万年2;   

  1. 1.北京结核病控制研究所 北京 100035; 2.首都医科大学公卫学院 北京 100054;
  • 出版日期:2003-06-10 发布日期:2003-11-03

A five-year study on the outcome of initial smear-p ositive pulmona ry tuberculosis cases treated under DOTS in rural areas of Beijing

LI Bo 1,TU De-hua,LIANG Wan-nian.   

  1. Beijing Research I nstitute for Tuberculosis Control,Beijing 100035
  • Online:2003-06-10 Published:2003-11-03

摘要: 目的 评价北京市农村 (1 0个远郊区县 )DOTS病人的 5年转归并分析导致复发和治疗失败的有关影响因素。方法 采用队列研究的方法,对北京市农村1995年新登记的全部初治涂阳肺结核病人的5年转归进行分析评价。结果 1995年北京市农村全部初治涂阳肺结核病人中,按照严格标准要求,符合DOTS标准的病人共有272例,占病人总数的72.8%。监化组和自服药组在疗程结束时的治愈率分别为95.2%和88.2%,有显著性差异(P<0.05)。监化组和自服药组的5年随访细菌学复发率分别为1.4%和9.1%,有显著性差异(P<0.01)。共有372例病人参加治疗,初治失败6例,5年随访细菌学复发11例,经再次治疗,只有1例最终成为慢性传染源。导致复发和治疗失败的主要影响因素是不规律服药。结论 在北京市农村地区,DOTS策略取得了良好的近远期效果,证明DOTS是控制传染源的非常有效的措施。结核病控制工作应把主要的人力、物力用于监督病人化疗的实施上

关键词: 结核,肺/预防和控制, 全面监督下短程化学疗法

Abstract: Objective To evaluate the long-term efficacy of DOTS strategy which implemented in rural areas (include 10 rural districts and co unties) of Beijing in 1995,and to analyze the possible influence factors which w ould lead to relapse and the failure of treatment.Methods To analyze the treatment outcome Results of all new reg istered initial smear positive cases in rural areas of Beijing in 1995 for five -years with cohort analysis.Results Under the strict standards of DOTS,the number of case w ho had been treated under DOTS were 272,which occupied 72.8% of total cases.The cure rates of DOTS group and self-administered group in the cohort analysis at the end of the treatment course were 95.2% and 88.2% respectively.And the differ ence between th e two groups was statistically significant (P<0.05).The relapse rate over 5 years was 1.4% and 9.1% respectively in DOTS and self-administered group,the d ifference between the two groups was significant (P<0.01).Among the 372 cas es who were treated,6 cases failed in the treatment,11 cases relapsed,but only o ne became the chronic infectious case after the retreament.The possible inf luence factors which led to relapse and the failure of treatment might be incomp liance with the treatment.Conclusion The short and the long-term efficacy of DOTS strate gy implemented in rural areas of Beijing is wonderful as expected.The top priori ty of tuberculosis control should be focus on supervision of chemotherapy treatm ent by input of human sources and investment.

Key words: Tuberculosis,pulmonary/prevention and control, DOTS