异烟肼联合利福喷丁方案在中国结核分枝杆菌潜伏感染者预防性治疗中的研究进展

doi:10.19982/j.issn.1000-6621.20250475

摘要/Abstract

摘要：

结核病是全球重大公共卫生挑战,我国结核分枝杆菌潜伏感染(LTBI)者超2亿,预防性治疗是实现终结结核病流行的关键路径。传统长疗程方案因依从性差导致治疗覆盖率低。异烟肼联合利福喷丁(H-P)方案凭借疗程短、治疗负担低的核心优势,通过针对性调整给药剂量与给药频率,已衍生出多种可适配不同人群的短程治疗方案。笔者系统梳理近10年国内相关临床研究进展,重点分析各类H-P短程方案在普通LTBI者及矽肺患者、血液透析患者、老年糖尿病患者等特殊群体中的治疗完成率、不良反应特征及预防效果,明确不同方案的临床适配场景与应用局限,以期为我国LTBI者临床安全有效选用H-P短程方案提供参考。

关键词: 分枝杆菌感染, 预防性治疗, 异烟肼, 利福喷丁

Abstract:

Tuberculosis (TB) remains a major global public health challenge. In China, the population with latent tuberculosis infection (LTBI) exceeds 200 million, and preventive therapy represents a pivotal pathway to ending the TB epidemic. Traditional long-course regimens are afflicted by low treatment coverage, stemming from poor patient adherence and concerns over adverse reactions. Endowed with the core advantages of shortened treatment duration and reduced therapeutic burden, the isoniazid-rifapentine (H-P) regimen has been further developed into a diverse array of short-course protocols tailored to distinct populations through targeted adjustment of dosage and administration frequency. The authors systematically review the advances in relevant domestic clinical researches over the past decade, with a focused analysis of treatment completion rate, adverse reaction profiles and preventive effectiveness of various H-P short-course regimens in both the general LTBI population and special populations including silicosis patients, hemodialysis recipients, elderly patients with diabetes. It further clarifies the clinical application scenarios and limitations of different regimens, aiming to provide evidence-based references for the safe and effective clinical selection of H-P short-course protocols for LTBI populations in China.

Key words: Latent tuberculosis infection, Preventive therapy, Isoniazid, Rifapentine

中图分类号:

杨涛, 宋燕红, 石小英, 郑远航, 钱凯, 李敬, 罗毅. 异烟肼联合利福喷丁方案在中国结核分枝杆菌潜伏感染者预防性治疗中的研究进展[J]. 中国防痨杂志, 2026, 48(7): 1064-1068. doi: 10.19982/j.issn.1000-6621.20250475

Yang Tao, Song Yanhong, Shi Xiaoying, Zheng Yuanhang, Qian Kai, Li Jing, Luo Yi. Clinical research progress on isoniazid combined with rifapentine regimen in Chinese population with latent tuberculosis infection[J]. Chinese Journal of Antituberculosis, 2026, 48(7): 1064-1068. doi: 10.19982/j.issn.1000-6621.20250475

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