耐药骨结核病的治疗结果:回顾性分析
Himanshu Gupta1, Rajesh Arora1, Manish Chadha1
1Department of Orthopaedics, Dilshad Garden, University College of Medical Sciences & Associated Guru Teg Bahadur Hospital, Delhi, 110095 India.
Indian journal of orthopaedics
|March 28, 2024
概括
对耐药性骨关节结核病 (DR-OATB) 的结果很差. 这项研究表明,个性化二线抗结核治疗 (ATT) 和基因型药物敏感性测试 (DST) 可以实现没有复发的治愈状态.
科学领域:
- 整形外科 整形外科 整形外科
- 传染性疾病 传染性疾病
- 放射学 放射学是一门学科.
背景情况:
- 药物耐药性骨关节结核病 (DR-OATB) 管理结果在历史上是令人丧的.
- 有限的研究记录了DR-OATB的治疗结果,需要进一步研究.
- 这一回顾性分析评估了连续的DR-OATB案件的结果.
研究的目的:
- 评估耐药性骨关节结核病的管理结果.
- 评估个性化二线抗结核治疗 (ATT) 和诊断方法的有效性.
- 为了确定治疗DR-OATB患者的复发率和不良事件.
主要方法:
- 从2010年起,对45名连续接受治疗的疑似DR-OATB患者进行了回顾性分析.
- 组织样本经过微生物学和基因型药物敏感性测试 (DST),包括CBNAAT/LPA.
- 患者接受了个性化的二线ATT,结果通过MRI/PET,临床状态和不良事件监测进行评估.
主要成果:
- 37名患者进行了随访;78%的患者具有微生物学证明的耐药性,其中18/29人具有多药性耐药性.
- 第二线ATT的平均持续时间为22.5个月,15名患者接受了手术减压.
- 所有患者都实现了愈合状态,其中21%的患者出现了肝毒性和耳毒性等副作用. 在至少2年的随访中没有观察到复发.
结论:
- 以基因型DST为指导的个性化二线ATT对DR-OATB有效.
- 临床怀疑与DST相结合,有助于诊断和管理DR-OATB.
- 在大量DR-OATB患者中,没有复发的治愈状态得到了实现.
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