关键词: 结核, 肺/药物疗法, 结核, 抗多种药物性/药物疗法, 甲状腺功能减退症, 丙硫异烟胺, 对氨基水杨酸, 临床方案

Abstract: Objective To investigate the incidence and the clinical characteristics induced by chemotherapy regimen containing prothionamide (Pto) and p-aminosalicylic acid granule (PAS) in anti-multi drug-resistant tuberculosis (MDR-TB)treatment and to develop preventive measures and treatment methods for hypothyroidism induced by Pto and PAS. Methods We analyzed 106 cases with MDR-TB who received standard chemotherapy regimen containing Pto and PAS(6 PZA Km(Cm) Lfx (Mfx) Pto PAS/18 PZA Lfx(Mfx) Pto PAS) from the research project supported by the 5^th round of the global funds projects during August 1, 2008 and April 1,2010 in Wuhan city. Thirty two cases experienced hypothyroidism were monitored by thyroid functions during treatment.The treatment outcomes were analyzed in 106 cases. There were 32 cases with hypothyroidism treated with levothyrocine(L-T₄) in 19 cases and without levothyrocine in 13 cases and 74 cases without hypothyroidism.  Results There were 32 cases experienced hypothyroidism in 106 cases. Thirty one cases with hypothyroidism were recovered after treatment and 1 cases died due to respiratory failure.The cure rates for MDR-TB with and without hypothyroidism were 68.8%（22/32）and 68.9%（51/74）respectively. The difference was insignificant statistically（χ²=0.19，P=0.66）. The cure rates for MDR-TB with hypothyroidism treated with L-T₄ and without L-T₄ were 68.4%（13/19）and 76.9%（10/13） respectively.The difference was insignificant statistically (χ²=0.28, P=0.60).  Conclusion The incidence of hypothyroidism tends to increase in MDR-TB patients treated with chemotherapy regimen containing Pto and PAS. Hypothyroidism can be controlled by taking the drug of L-T₄.The thyroid functions can be recovered after chemotherapy teatment.

Key words: Tuberculosis, pulmonary/drug therapy, Tuberculosis, multidrug-resistant/drug therapy, Hypothyroidism, Prothionamide, p-Aminosalicylic acid, Clinical protocols