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目的了解结核病固定剂量组合药物治疗方式的重症不良反应发生情况及其对结核病控制策略的影响。方法随访观组合药物短程化疗方案的痰涂片阳性肺结核患者1394例,同时查阅病历,数据资料通过SPSS17.0软件进行统计分析。结果对使用2HRZE/4H3R3、2HRZES/6H3R3E3短程化疗方案的痰菌阳性肺结核患者进行了调查,结果不良反应发生比例为28.26%,主要临床表现有胃肠道反应25.05%,过敏反应20.24%,关节损害16.28%,中枢神经症状13.65%,肝损害2.68%等。各药物不良反应发生比例分别为Z 20.24%,R 19.12%,H 15.26%,E 12.63%,S 4.68%。患者年龄、性别、强化治疗时间等对不良反应的发生均有一定程度的影响。结论固定剂量组合药物短程治疗肺结核不良反应发生比例高于普通剂量,一定程度上影响了患者对化疗方案的接受性。因此,在临床治疗过程中可酌情调整化疗方案。
Objective To understand the incidence of severe adverse reactions of tuberculosis fixed dose combination therapy and its effect on control strategy of tuberculosis. Methods A total of 1394 cases of sputum smear-positive pulmonary tuberculosis patients were included in the study. Drug records were collected and the data were analyzed by SPSS17.0 software. Results A total of 28.26% of patients with sputum-positive pulmonary tuberculosis were treated with 2HRZE / 4H3R3 and 2HRZES / 6H3R3E3 short-course chemotherapy. The main clinical manifestations were gastrointestinal reaction (25.05%), anaphylactic reaction (20.24%), joint damage 16.28%, CNS symptoms 13.65%, liver damage 2.68% and so on. The incidence of adverse reactions of each drug were Z 20.24%, R 19.12%, H 15.26%, E 12.63%, S 4.68%. The patient’s age, sex and intensive treatment time all had a certain degree of influence on the occurrence of adverse reactions. Conclusion The fixed dose combination drug short-course treatment of tuberculosis adverse reactions occurred higher than the average dose, to a certain extent, affected the patient’s acceptance of chemotherapy regimens. Therefore, in the course of clinical treatment can be adjusted as appropriate chemotherapy.