Outcome of pulmonary multidrug-resistant tuberculosis: a 6-yr follow-up study
Outcome of pulmonary multidrug-resistant tuberculosis: a 6-yr follow-up study
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DOI：
10.1183/09031936.06.00125705
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发表时间：
2006-11-01
影响因子：
24.3
通讯作者：
Lin, T-P.
中科院分区：
文献类型：
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作者：
Chiang, C-Y.;Enarson, D. A.;Lin, T-P.
为探讨耐多药肺结核（MDR-TB）预后的相关因素，本研究以台北市某转诊中心1992-1996年新诊断的MDR-TB患者为研究对象，分析其6年内的预后，共纳入299例患者，男215例（71.9%），女84例（28.1%），平均年龄47.3岁，平均用药3.7种。在299例患者中，153例（51.2%）治愈，31例（10.4%）失败，28例（9.4%）死亡，87例（29.1%）失访。125例接受氧氟沙星二线治疗的患者中，74例（59.2%）治愈。接受氧氟沙星治疗的患者比仅接受一线药物治疗的患者复发风险低（风险比（HR）0.16，95%置信区间（CI）0.03-0.81），与接受二线药物但未接受氧氟沙星治疗的患者相比，（校正HR 0.509 95%CI 0.31-0.82）。总之，接受氧氟沙星治疗的耐多药肺结核患者治愈的可能性更高，死亡、失败或复发的可能性更低。新一代氟喹诺酮类药物，如阿氟沙星，在治疗耐多药结核病的效用需要进行评估。不接受治疗是耐多药结核病治疗中的一个重大挑战。
A retrospective study was performed to determine factors associated with the outcome of pulmonary multidrug-resistant tuberculosis (MDR-TB) in Taipei, Taiwan.All patients newly diagnosed with pulmonary MDR-TB in a referral centre from 1992-1996 were enrolled and their outcome over the subsequent 6 yrs was determined.A total of 299 patients were identified, comprising 215 (71.9%) males and 84 (28.1%) females with a mean age of 47.3 yrs. The patients received a mean of 3.7 effective drugs. Out of the 299 patients, 153 (51.2%) were cured, 31 (10.4%) failed, 28 (9.4%) died and 87 (29.1%) defaulted. Of the 125 patients receiving second-line drugs with ofloxacin, 74 (59.2%) were cured. Those who received ofloxacin had a lower risk of relapse than those receiving only first-line drugs (hazard ratio (HR) 0.16, 95% confidence interval (CI) 0.03-0.81) and a lower risk of TB-related death than those receiving second-line drugs but not ofloxacin (adjusted HR 0.509 95% Cl 0.31-0.82).In conclusion, multidrug-resistant tuberculosis patients who received ofloxacin were more likely to be cured, and were less likely to die, fail or relapse. The utility of new-generation fluoroquinolones, such as moxifloxacin, in the treatment of multidrug-resistant tuberculosis needs to be evaluated. Default from treatment is a major challenge in the treatment of multidrug-resistant tuberculosis.