Chinese Journal of Antituberculosis ›› 2021, Vol. 43 ›› Issue (11): 1146-1152.doi: 10.3969/j.issn.1000-6621.2021.11.008
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TIAN Dan, HU Xiao-meng, JIN Wu, CHENG Chang-hao, XIONG Lei-qun, HU Rong-hua, JIN Qian, LIU Yun, DU Juan()
Received:
2021-07-14
Online:
2021-11-10
Published:
2021-11-02
Contact:
DU Juan
E-mail:dudu1109@126.com
TIAN Dan, HU Xiao-meng, JIN Wu, CHENG Chang-hao, XIONG Lei-qun, HU Rong-hua, JIN Qian, LIU Yun, DU Juan. Sixty-seven MDR-,and XDR-PTB cases with sputum culture conversion then treated with bedaquiline-containing regimens: A singal arm, single center observational study[J]. Chinese Journal of Antituberculosis, 2021, 43(11): 1146-1152. doi: 10.3969/j.issn.1000-6621.2021.11.008
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治疗时间 | 例数 | 病灶 | 例数 | 空洞 | |||||||
---|---|---|---|---|---|---|---|---|---|---|---|
明显吸收 | 吸收 | 不变 | 恶化 | 闭合 | 缩小 | 不变 | 增大 | ||||
12周 | 67 | 8(11.9) | 42(62.7) | 15(22.4) | 2(3.0) | 20 | 10(50.0) | 5(25.0) | 5(25.0) | 0(0.0) | |
24周 | 63 | 12(19.0) | 44(69.8) | 7(11.1) | 0(0.0) | 19 | 14(73.7) | 2(10.5) | 3(15.8) | 0(0.0) | |
36周 | 60 | 22(36.7) | 34(56.7) | 3(5.0) | 1(1.7) | 17 | 15(88.2) | 1(5.9) | 1(5.9) | 0(0.0) | |
48周 | 57 | 26(45.6) | 27(47.4) | 4(7.0) | 0(0.0) | 17 | 16(94.1) | 0(0.0) | 1(5.9) | 0(0.0) | |
80~88周 | 57 | 26(45.6) | 29(50.9) | 2(3.5) | 0(0.0) | 17 | 16(94.1) | 0(0.0) | 1(5.9) | 0(0.0) |
AE分类 | 例次 (率,%) | Ⅰ级 (例次) | Ⅱ级 (例次) | Ⅲ级 (例次) | Ⅳ级 (例次) | Ⅴ级 (例次) | 时间 [周,M(Q1,Q3)] |
---|---|---|---|---|---|---|---|
心电图异常 | |||||||
QTc延长 | 21(11.5) | 1 | 5 | 15 | 0 | 0 | 12.0(3.5,22.0) |
房扑 | 1(0.5) | 0 | 1 | 0 | 0 | 0 | NA |
肝功能异常 | 66(36.3) | ||||||
ALT升高 | 16(8.8) | 10 | 5 | 1 | 0 | 0 | 13.5(2.5,38.0) |
AST升高 | 38(20.9) | 34 | 4 | 0 | 0 | 0 | 24.0(4.8,40.5) |
Tbil升高 | 5(2.7) | 5 | 0 | 0 | 0 | 0 | 28.0(3.0,43.5) |
GGT升高 | 4(2.2) | 1 | 3 | 0 | 0 | 0 | 5.0(1.5,19.8) |
ALP升高 | 3(1.6) | 3 | 0 | 0 | 0 | 0 | 3.0(1.0,7.0) |
肾功能异常 | 10(5.5) | ||||||
肌酐升高 | 3(1.6) | 3 | 0 | 0 | 0 | 0 | NA |
高尿酸血症 | 7(3.8) | 0 | 5 | 2 | 0 | 0 | 4.0(2.0,8.0) |
骨髓抑制 | 57(31.3) | ||||||
白细胞减少 | 14(7.7) | 2 | 12 | 0 | 0 | 0 | 4.0(2.0,10.0) |
中性粒细胞减少 | 12(6.6) | 1 | 9 | 2 | 0 | 0 | 3.0(2.0,8.0) |
贫血 | 26(14.3) | 8 | 12 | 5 | 1 | 0 | 4.0(1.0,8.0) |
血小板减少 | 5(2.7) | 2 | 0 | 3 | 0 | 0 | 28.0(10.0,28.5) |
低钾血症 | 6(3.3) | 5 | 1 | 0 | 0 | 0 | 10.0(1.0,21.0) |
症状或体征 | |||||||
视力减退/视物模糊 | 6(3.3) | 0 | 0 | 6 | 0 | 0 | 28.0(18.0,56.0) |
耳鸣 | 1(0.5) | 0 | 1 | 0 | 0 | 0 | NA |
神经系统症状 | 4(2.2) | 0 | 1 | 3 | 0 | 0 | NA |
精神系统症状 | 3(1.6) | 0 | 1 | 2 | 0 | 0 | NA |
胃肠道症状 | 3(1.6) | 1 | 1 | 1 | 0 | 0 | NA |
死亡 | 4(2.2) | 0 | 0 | 0 | 0 | 4 | 28.0(14.0,45.0) |
[1] |
任坦坦, 陆普选, 邓国防, 等. 2020 WHO全球结核报告:全球与中国关键数据分析. 新发传染病电子杂志, 2020, 5(4):280-284. doi: 10.19871/j.cnki.xfcrbzz.2020.04.015.
doi: 10.19871/j.cnki.xfcrbzz.2020.04.015 |
[2] |
Koul A, Vranckx L, Dendouga N, et al. Diarylquinolines are bactericidal for dormant mycobacteria as a result of disturbed ATP homeostasis. J Biol Chem, 2008, 283(37):25273-25280. doi: 10.1074/jbc.M 803899200.
doi: 10.1074/jbc.M 803899200 |
[3] |
Maher D, Dye C, Floyd K, et al. Planning to improve global health: the next decade of tuberculosis control. Bull World Health Organ, 2007, 85(5):341-347. doi: 10.2471/blt.06.037820.
doi: 10.2471/blt.06.037820 |
[4] |
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, 47(10):1025-1073. doi: 10.3969/j:issn.1000-6621.2019.10.001.
doi: 10.3969/j:issn.1000-6621.2019.10.001 |
[5] | World Health Organization. WHO treatment guidelines for multidrug and rifampicin resistant tuberculosis 2018 update Pre-final text. Geneva: World Health Organization, 2018. |
[6] |
中华医学会结核病学分会. 中国耐多药和利福平耐药结核病治疗专家共识(2019年版). 中华结核和呼吸杂志, 2019, 42(10):733-749. doi: 10.3760/cma.j.issn.1001-0939.2019.10.006.
doi: 10.3760/cma.j.issn.1001-0939.2019.10.006 |
[7] |
Matteelli A, Carvalho AC, Dooley KE, et al. TMC207: the first compound of a new class of potent anti-tuberculosis drugs. Future Microbiol, 2010, 5(6):849-858. doi: 10.2217/fmb.10.50.
doi: 10.2217/fmb.10.50 |
[8] |
Andries K, Verhasselt P, Guillemont J, et al. A diarylquinoline drug active on the ATP synthase of Mycobacterium tuberculosis. Science, 2005, 307(5707):223-227. doi: 10.1126/science.1106753.
doi: 10.1126/science.1106753 |
[9] |
Huitric E, Verhasselt P, Andries K, et al. In vitro antimycobacterial spectrum of a diarylquinoline ATP synthase inhibitor. Antimicrob Agents Chemother, 2007, 51(11):4202-4204. doi: 10.1128/AAC.00181-07.
doi: 10.1128/AAC.00181-07 |
[10] |
Lounis N, Veziris N, Chauffour A, et al. Combinations of R207910 with drugs used to treat multidrug-resistant tuberculosis have the potential to shorten treatment duration. Antimicrob Agents Chemother, 2006, 50(11):3543-3547. doi: 10.1128/AAC.00766-06.
doi: 10.1128/AAC.00766-06 |
[11] |
Borisov SE, Dheda K, Enwerem M, et al. Effectiveness and safety of bedaquiline-containing regimens in the treatment of MDR- and XDR-TB: a multicentre study. Eur Respir J, 2017, 49(5):1700387. doi: 10.1183/13993003.00387-2017.
doi: 10.1183/13993003.00387-2017 |
[12] |
Conradie F, Diacon AH, Ngubane N, et al. Treatment of Highly Drug-Resistant Pulmonary Tuberculosis. N Engl J Med, 2020, 382(10):893-902. doi: 10.1056/NEJMoa1901814.
doi: 10.1056/NEJMoa1901814 |
[13] |
Collaborative Group for the Meta-Analysis of Individual Patient Data in MDR-TB treatment-2017, Ahmad N, Ahuja SD, et al. Treatment correlates of successful outcomes in pulmonary multidrug-resistant tuberculosis: an individual patient data meta-analysis. Lancet, 2018, 392(10150):821-834. doi: 10.1016/S0140-6736(18)31644-1.
doi: 10.1016/S0140-6736(18)31644-1 |
[14] |
Cohen K, Maartens G. A safety evaluation of bedaquiline for the treatment of multi-drug resistant tuberculosis. Expert Opin Drug Saf, 2019, 18(10):875-882. doi: 10.1080/14740338.2019.1648429.
doi: 10.1080/14740338.2019.1648429 |
[15] |
Gao M, Gao J, Xie L, et al. Early outcome and safety of bedaquiline-containing regimens for treatment of MDR- and XDR-TB in China: a multicentre study. Clin Microbiol Infect, 2021, 27(4):597-602. doi: 10.1016/j.cmi.2020.06.004.
doi: 10.1016/j.cmi.2020.06.004 |
[16] |
时正雨, 吴桂辉, 黄涛, 等. 含贝达喹啉方案治疗耐多药/广泛耐药结核病的24周单组观察性研究. 中国防痨杂志, 2021, 43(5):487-494. doi: 10.3969/j.issn.1000-6621.2021.05.014.
doi: 10.3969/j.issn.1000-6621.2021.05.014 |
[17] |
Chakaya J, Khan M, Ntoumi F, et al. Global Tuberculosis Report 2020-Reflections on the Global TB burden, treatment and prevention efforts. Int J Infect Dis, 2021. doi: 10.1016/j.ijid.2021.02.107.
doi: 10.1016/j.ijid.2021.02.107 |
[18] |
Lan Z, Ahmad N, Baghaei P, et al. Drug-associated adverse events in the treatment of multidrug-resistant tuberculosis: an individual patient data meta-analysis. Lancet Respir Med, 2020, 8(4):383-394. doi: 10.1016/S2213-2600(20)30047-3.
doi: 10.1016/S2213-2600(20)30047-3 |
[19] |
Vasilyeva I, Mariandyshev A, Kazennyy B, et al. Early access to bedaquiline for extensively drug-resistant (XDR) and pre-XDR tuberculosis. Eur Respir J, 2019, 54(1):1802208. doi: 10.1183/13993003.02208-2018.
doi: 10.1183/13993003.02208-2018 |
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