CAJ | 학술논문

目的：探讨环丝氨酸联合抗结核药物治疗耐多药肺结核（multi-drug resistant tuberculosis, MDR-TB）的疗效及安全性。方法选择2012年5—11月广西南宁市第四人民医院纳入第五轮中国全球基金耐多药结核病防治项目的MDR-TB患者98例，将其分为试验组（n=50）和对照组（n=48）。2组患者均接受标准MDR-TB治疗方案，在此基础上试验组加用环丝氨酸，对照组加用对氨基水杨酸。分别对2种不同治疗方法的疗效和不良反应进行比较。结果2组治疗第3、6、9、12、24月末痰菌阴转率差异无统计学意义（P>0.05）。试验组中枢神经系统不良反应和周围神经病变发生率高于对照组，而对照组胃肠道反应及药物性肝损伤的发生率远高于试验组，差异有统计学意义（P<0.01）。结论环丝氨酸和对氨基水杨酸在治疗MDR-TB方面效果相当，但可引起诸多不良反应，值得深入研究。
목적：탐토배사안산연합항결핵약물치료내다약폐결핵（multi-drug resistant tuberculosis, MDR-TB）적료효급안전성。방법선택2012년5—11월엄서남저시제사인민의원납입제오륜중국전구기금내다약결핵병방치항목적MDR-TB환자98례，장기분위시험조（n=50）화대조조（n=48）。2조환자균접수표준MDR-TB치료방안，재차기출상시험조가용배사안산，대조조가용대안기수양산。분별대2충불동치료방법적료효화불량반응진행비교。결과2조치료제3、6、9、12、24월말담균음전솔차이무통계학의의（P>0.05）。시험조중추신경계통불량반응화주위신경병변발생솔고우대조조，이대조조위장도반응급약물성간손상적발생솔원고우시험조，차이유통계학의의（P<0.01）。결론배사안산화대안기수양산재치료MDR-TB방면효과상당，단가인기제다불량반응，치득심입연구。
Objective To investigate the efficacy and safety of the combination use of cycloserine and anti-tuberculosis (TB) drugs for multi-drug resistant TB (MDR-TB). Methods A total of 98 patients treated in Fourth People's Hospital of Nanning, who wereenrolled in the global round 5 MDR-TB fund project, were selected. All the patients were divided into 2 groups, an experimental group (n=50) and a control group (n=48). Based on standard MDR-TB treatment, the experimental group was given cycloserine and the control group para-aminosalicylic acid additionally. The therapeutic efficacy and adverse reactions of the 2 groups were com-pared. Results The sputum negative conversion rates at months 3, 6, 9, 12, and 24 of treatment were not significantly different be-tween the experimental group and the control group (P>0.05). The occurrence of adverse reactions in central nerve system and peripheral neuropathy in the experimental group was significantly higher than that in the control group, while the occurrence of adverse reactions in gastrointestinal tract and drug-induced liver injury in the control group was significantly higher than that in the experimental group (P<0.01). Conclusions Cycloserine and para-aminosalicylic acid are equally effective in treatment of MDR-TB. However, they may cause adverse reactions, which should be studied deeply.