母牛分枝杆菌辅助治疗复治涂阳肺结核疗效观察

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1、母牛分枝杆菌辅助治疗复治涂阳肺结核疗效观察摘要目的：观察和评价母牛分枝杆菌（微卡）在复治涂阳肺结核免疫治疗中的疗效。方法：将102例复治涂阳肺结核患者随机分为微卡加化疗治疗组与单纯化疗对照组各51例，两组均采用2S3H3R3Z3E3/6H3R3E3化疗方案。观察治疗结束后肺部病灶吸收、空洞闭合、痰菌阴转、不良反应及停药2年后细菌学复发情况。结果：第2个月末痰菌阴转率治疗组和对照组分别为74.5%和49.0%,两组比较，有极显著性差异（P〈0.01）。疗程结束后痰菌阴转率治疗组和对照组分别为92.2%和74.5%,治疗组明显高于对照组，两组比较有显著性差异（P〈0.05）；肺部病灶吸收好

2、转率分别为82.4%和58.8%,差异有极显著性（P<0.01）；空洞闭合+缩小率分别为68.4%和44.4%,有显著性差异（P〈0.05）。停药2年后治疗组和对照组细菌学复发率分别为4.0%和12.2%,差异无显著性（P>0.05）o结论：微卡能加速痰菌阴转，有助于病灶吸收，辅助治疗复治涂阳肺结核有显著性疗效。❷关键词结核肺微卡复治涂阳❷AbstractObjective：ToobserveandappraisetheeffectofMycobacteriumvaccaeontheimmunitytreatmentofrecurrenttreatedsmearpositivepulm

3、onarytuberculosis.Methods:102examplesweredividedintotwogroupsinaverageatrandom.Theformergroupwastreatedwith2S3H3R3Z3E3/6H3R3E3andMycobacteriumvaccae,whereasthelatterwastreatedbychemotherapyonly,whenthetreatmentwasendedtoobservthelesionimprovement,thecavityclosure,thesputumbacteriologicalnegative

4、ratesandtheadversereaction.AfterStoppedmedicinefortwoyeartoobservetherelapseratesonbacteriology.Results：With2months?treatmentthesputumbacteriologicaInegativeratesoftheobservedgroupandthecontrolgroupwere74.5%and49.0%andthedifferenceofthemwasextremelysignificant(P<0.01)・Afterthetreatmenttheratesre

5、spectivelywere92.2%and74.5%andtheformergroupweresignificantlydifferentfromthelatter(P<0.05),thelesionimprovementratesofthetwogroupswere82.4%and58.8%(P<0.01),thecavityclosureratesofthosewere68.4%and44.4%(P<0.05)・Afterthetreatmentfortwoyearstherelapseratesonbacteriologywere4.0%and12.2%(P>0.05).Con

6、clusion:Mycobacteriumvaccaeimprovesthesputumnegativeratesandlesionabsorptionandmightbevalueonthetreatmentofrecurrentsmearpositivepulmonarytuberculosis•❷KeywordsTuberculosis；Pulmonary；Mycobacteriumvaccae；Thetreatmentofrecurrentsmearpositive❷对象与方法❷对象：2003〜2005年所选病例均为结核病项目门诊登记、治疗和管理的复治肺结核患者。诊断符合我国现

7、行的复治肺结核定义[1],痰涂片均为阳性。年龄18〜67岁的非孕妇，无严重心、肝、肾和关节疾病，无矽肺、糖尿病和精神病史，无免疫变态反应性疾病，近3个月未用其他免疫制剂者。102例患者中男63例，女39例，平均年龄43.8岁。将102例患者随机分成两组。微卡治疗组51例，单纯化疗对照组51例。两组年龄、性别、病情具有可比性(P>0.05)o治疗方案：治疗组和对照组均采用WHO推荐的标准间歇化疗方案：2S3H3R3Z3E3/6H3R3E3O疗程8