肺结核患者抗结核治疗不良反应临床分析

发布时间：2018-08-19 06:35

【摘要】：目的比较初/复治肺结核患者治疗过程中不良反应发生情况,为临床医生提供参考。方法整理和分析"艾滋病和病毒性肝炎等重大传染病防治"国家科技重大专项课题中相关数据,分析、比较初/复治肺结核患者治疗过程中发生的不良反应类型、发生率及预后。结果在结核病治疗过程中患者肝功能异常和胃肠道反应发生率较高,分别为初治10.01%、复治6.17%和初治6.33%、复治7.10%,初治组肝功能异常发生率与复治组比较差异有统计学意义(P0.05);关节肌肉痛发生率初治组为1.21%,复治组为2.78%,差异有统计学意义(P0.05)。其他类型不良反应(肝功/肾功损害、血液系统、药物过敏、神经精神症状、听神经、视神经及胃肠道反应)发生率二组比较差异无统计学意义(P0.05)。初治组肝功/肾功损害、血液系统、药物过敏、神经精神症状等不良反应出现的时间分别为66.11、56.18、45.81、37.86、44.1d,较复治组早;复治组听神经、视神经及肌肉、关节损害出现时间为87.63、27.33、50.50d,较初治组早,其中出现最早的是视神经损害。初/复治组的耐药性与不良反应的发生无关(P0.05)。初治组有不良反应患者的治愈率为87.4%,无不良反应患者的治愈率为89.7%,差异无统计学意义(P0.05),治愈率与复治组比较差异有统计学意义(P0.01);复治组有不良反应病例的治愈率61.54%,无不良反应病例的治愈率为78.95%,二者差异有统计学意义(P0.01);结论接受国标法治疗的肺结核患者初治和复治中不良反应的发生类型和时间均不同,且复治病例不良反应的发生影响预后。
[Abstract]:Objective to compare the incidence of adverse reactions in primary / recurrent pulmonary tuberculosis patients and to provide reference for clinicians. Methods to analyze and analyze the relevant data in the national scientific and technological project "Prevention and treatment of major infectious diseases such as AIDS and viral hepatitis", and to compare the types of adverse reactions in the course of treatment of patients with primary / recurrent pulmonary tuberculosis. Incidence and prognosis. Results the incidence of abnormal liver function and gastrointestinal reaction was higher in patients with tuberculosis. The incidence of liver dysfunction in the initial treatment group was significantly higher than that in the control group (P0.05); the incidence of joint muscle pain was 1.21 in the primary treatment group and 2.78 in the retard group (P0.05). There was no significant difference in the incidence of other adverse reactions (liver / kidney dysfunction, blood system, drug allergy, neuropsychiatric symptoms, auditory nerve, optic nerve and gastrointestinal reactions) between the two groups (P0.05). The time of occurrence of adverse reactions such as liver / kidney dysfunction, blood system, drug allergy and neuropsychiatric symptoms in the primary treatment group was 66.11 / 56.181.45.81and 37.86,44.1 days earlier than that in the retreated group, and the onset time of acoustic nerve, optic nerve, muscle and joint damage in the treated group was 87.6327.333,30.50 days, which was earlier than that in the first treated group. Among them, the earliest is optic nerve damage. There was no correlation between drug resistance and adverse reaction in the primary / recurrent group (P 0.05). The cure rate of the patients with adverse reactions in the first treatment group was 87.4, and the cure rate in the patients without adverse reactions was 89.7.The difference was not statistically significant (P0.05), the cure rate was significantly higher than that in the retard group (P0.01), and the cure rate of the patients with adverse reactions in the re-treated group was higher than that in the re-treated group (P0.01). 61.54, the cure rate of the patients without adverse reactions was 78.95, the difference between them was statistically significant (P0.01). Conclusion the types and time of adverse reactions in patients with pulmonary tuberculosis treated by national standard method are different. The prognosis was affected by adverse reactions in patients with recurrent treatment.
【作者单位】：内蒙古医科大学公共卫生学院;北京市结核病胸部肿瘤研究所;首都医科大学附属北京胸科医院;内蒙古医科大学基础医学院;
【基金】：国家科技重大专项(No.2008ZX10003-015-2)
【分类号】：R521

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