贵州医科大学学报

2016, v.41;No.188(05) 597-599

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耐多药结核病抗结核治疗依从性与药物不良反应
Compliance and Adverse Reactions in Anti tuberculosis Treatment of Multi Drug Resistant Tuberculosis

张廷梅;熊敏;陈静;
ZHANG Tingmei;XIONG Min;CHEN Jing;Guiyang public health center;

摘要(Abstract):

目的:了解耐多药结核病(MDR-TB)患者对抗结核药物的依从性。方法:选择76例MDR-TB并接受二线抗结核药物治疗的患者,采用阿米卡星(Am)及左氧氟沙星(Lfx)为核心药物的4种抗结核药物联合治疗方案,期间给予督导干预,比较治疗前后(治疗后6月、12月及18月)MDR-TB患者对抗结核治疗的依从性,同时观察患者的不良反应。结果:与治疗前比较,治疗后6月、12月及18月MDR-TB患者的依从性明显提高,差异有统计学意义(P<0.001);治疗后组间比较,差异无统计学意义(P>0.05);患者对抗结核治疗依从性差的主要原因是药物不良反应及对疾病认识不足,不良反应以抗结核药物注射局部皮下硬结、皮肤红染、血尿酸高、关节疼痛疼痛及肝功能损害为主。结论:加强对MDR-TB患者治疗过程中的督导干预,可提高抗结核治疗的依从性。
Objective: To investigate the compliance of patients with multiple drug resistant tuberculosis( MDR-TB) to anti-tuberculosis drugs. Methods: 76 cases of patients with MDR-TB receiving treatment of second-line anti-tuberculosis drugs were selected and enrolled in the study. They received a combined drug treatment in which Amikacin( Am) and Levofloxacin( Lfx) were core drugs combined with other 2 anti-tuberculosis drugs. During the treatment period,supervisory intervention was given.The MDR-TB patients ' compliance to anti-tuberculosis treatment was compared between before treatment and after treatment( 6 months,12 months,18 months after treatment) and meanwhile the adverse reactions in patients were observed. Results: Compared with before treatment,the patients' compliance to anti-tuberculosis treatment 6 months,12 months,18 months after treatment was significantly increased( P < 0. 001). There was no statistical difference in patients' compliance between groups after treatment( P > 0. 05). The main reasons for poor compliance of patients to anti-tuberculosis treatment were drug adverse reaction and lack of awareness of the disease. Adverse reactions were mainly localized subcutaneous induration caused by injection of anti-tuberculosis drugs,skin irritation,high uric acid in the blood,joint pain and liver function damage. Conclusion: To strengthen the supervision and intervention in the treatment of MDR-TB patients can improve the patients' compliance to anti-tuberculosis treatment.

关键词(KeyWords): 结核;抗结核药;抗药性,多药;依从性
tuberculosis;anti tuberculosis drugs;drug tolerance;multi drug;compliance

Abstract:

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作者(Author): 张廷梅;熊敏;陈静;
ZHANG Tingmei;XIONG Min;CHEN Jing;Guiyang public health center;

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DOI: 10.19367/j.cnki.1000-2707.2016.05.027

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