耐药肺结核流行现状及相关研究进展
Prevalence of Drug-Resistant Tuberculosis and Related Research Progress
摘要: 耐药肺结核是指结核病患者感染了耐药的结核分枝杆菌,使得结核病的治疗效果降低,病情加重,增加治疗难度,增加治疗费用,导致病情反复发作,尤其是耐多药肺结核的传染周期长,治疗难度大,治疗费用高,治愈率低,死亡率高。分析耐药肺结核的影响因素,对患者实施个体化治疗至关重要。耐药结核病存在多种治疗策略,化学治疗仍然被视为对抗耐药结核病最为关键的方法。本文将概述国内外耐药结核病的流行状况及其治疗方法,旨在为临床优化与提升耐药结核病的治疗效果提供参考依据。
Abstract: Drug-resistant tuberculosis refers to when tuberculosis patients are infected with drug-resistant Mycobacterium tuberculosis, which reduces the treatment effect of tuberculosis, aggravates the condition, increases the difficulty of treatment, increases the cost of treatment, and leads to repeated attacks of the disease, especially multidrug-resistant tuberculosis, which has a long infection cycle, difficult treatment, high treatment cost, low cure rate and high mortality. It is important to analyze the influencing factors of drug-resistant tuberculosis to implement individualized treatment for patients. There are multiple treatment strategies for drug-resistant TB, and chemotherapy is still considered the most critical approach in the fight against drug-resistant TB. This article will summarize the prevalence and treatment methods of drug-resistant tuberculosis at home and abroad, aiming to provide reference for clinical optimization and improvement of the therapeutic effect of drug-resistant tuberculosis.
文章引用:姚阳阳, 谷蓉蓉, 白智远. 耐药肺结核流行现状及相关研究进展[J]. 临床医学进展, 2024, 14(8): 1156-1161. https://doi.org/10.12677/acm.2024.1482334

参考文献

[1] World Health Organization (2023) Global Tuberculosis Report 2023.
https://cdn.who.int/media/docs/default-source/hq-tuberculosis/global-tuberculosis-report-2023/global-tb-report-2023-factsheet.pdf?sfvrsn=f0dfc8a4_3&download=true
[2] 韩萍. 耐药结核病的流行现状及其治疗[J]. 上海医药, 2022, 43(15): 3-5+9.
[3] Zhang, J., Gou, H., Hu, X., Hu, X., Shang, M., Zhou, J., et al. (2016) Status of Drug-Resistant Tuberculosis in China: A Systematic Review and Meta-Analysis. American Journal of Infection Control, 44, 671-676. [Google Scholar] [CrossRef] [PubMed]
[4] 赵飞, 杜昕, 李涛, 等. 基于世界卫生组织公共数据库的中国结核病流行趋势与预测[J]. 临床药物治疗杂志, 2018, 16(4): 1-3+8.
[5] Pedersen, O.S., Holmgaard, F.B., Mikkelsen, M.K.D., Lange, C., Sotgiu, G., Lillebaek, T., et al. (2023) Global Treatment Outcomes of Extensively Drug-Resistant Tuberculosis in Adults: A Systematic Review and Meta-Analysis. Journal of Infection, 87, 177-189. [Google Scholar] [CrossRef] [PubMed]
[6] 杜姗姗, 沙巍. 肺结核短疗程治疗的研究进展[J]. 同济大学学报(医学版), 2024, 45(2): 303-309.
[7] World Health Organization (2022) Global Tuberculosis Report 2022.
[8] World Health Organization (2021) Meeting Report of the WHO Expert Consultation on the Definition of Extensively Drug-Resistant Tuberculosis.
[9] 首都医科大学附属北京胸科医院, 北京市结核病胸部肿瘤研究所, 中国防痨协会《中国防痨杂志》编辑委员会. 耐药肺结核全口服化学治疗方案中国专家共识(2021年版) [J]. 中国防痨杂志, 2021, 43(9): 859-866.
[10] Bagcchi, S. (2023) Who’s Global Tuberculosis Report 2022. The Lancet Microbe, 4, e20. [Google Scholar] [CrossRef] [PubMed]
[11] 周文强, 张爽, 初乃惠. 耐药肺结核全口服治疗方案研究的现状和展望[J]. 中国防痨杂志, 2021, 43(9): 879-882.
[12] Conradie, F., Diacon, A.H., Ngubane, N., Howell, P., Everitt, D., Crook, A.M., et al. (2020) Treatment of Highly Drug-Resistant Pulmonary Tuberculosis. New England Journal of Medicine, 382, 893-902. [Google Scholar] [CrossRef] [PubMed]
[13] Conradie, F., Bagdasaryan, T.R., Borisov, S., Howell, P., Mikiashvili, L., Ngubane, N., et al. (2022) Bedaquiline-Pretomanid-Linezolid Regimens for Drug-Resistant Tuberculosis. New England Journal of Medicine, 387, 810-823. [Google Scholar] [CrossRef] [PubMed]
[14] Nyang’wa, B., Berry, C., Kazounis, E., Motta, I., Parpieva, N., Tigay, Z., et al. (2022) A 24-Week, All-Oral Regimen for Rifampin-Resistant Tuberculosis. New England Journal of Medicine, 387, 2331-2343. [Google Scholar] [CrossRef] [PubMed]
[15] World Health Organization (2022) WHO Consolidated Guidelines on Tuberculosis: Module 4: Treatment-Drug-Resistant Tuberculosis Treatment, 2022 Update.
https://www.who.int/teams/global-tuberculosis-programme/tb-reports/global-tuberculosis-report-2022
[16] Solans, B.P., Imperial, M.Z., Olugbosi, M. and Savic, R.M. (2023) Analysis of Dynamic Efficacy Endpoints of the Nix-Tb Trial. Clinical Infectious Diseases, 76, 1903-1910. [Google Scholar] [CrossRef] [PubMed]
[17] Lee, M., Lee, J., Carroll, M.W., Choi, H., Min, S., Song, T., et al. (2012) Linezolid for Treatment of Chronic Extensively Drug-Resistant Tuberculosis. New England Journal of Medicine, 367, 1508-1518. [Google Scholar] [CrossRef] [PubMed]
[18] 陈津红. 利奈唑胺用于耐多药肺结核治疗的现状[J]. 天津药学, 2022, 34(5): 67-73.
[19] Agyeman, A.A. and Ofori-Asenso, R. (2016) Efficacy and Safety Profile of Linezolid in the Treatment of Multidrug-Resistant (MDR) and Extensively Drug-Resistant (XDR) Tuberculosis: A Systematic Review and Meta-Analysis. Annals of Clinical Microbiology and Antimicrobials, 15, Article No. 41. [Google Scholar] [CrossRef] [PubMed]
[20] 中华医学会结核病学分会. 中国耐多药和利福平耐药结核病治疗专家共识(2019年版) [J]. 中华结核和呼吸杂志, 2019, 42(10): 733-749.
[21] World Health Organization (2018) Rapid Communication: Key Changes to the Treatment of Drug-Resistant Tuberculosis.
[22] 朱艳丽. 耐药结核病的诊疗新进展[J]. 中国社区医师, 2022, 38(15): 6-8.
[23] 周文强, 初乃惠. 耐药结核病治疗的进展[J]. 中国临床医生杂志, 2021, 39(7): 385-391.
[24] 高文英, 李涛. 经支气管镜介入治疗耐多药肺结核临床观察[J]. 中国医学工程, 2014, 22(9): 131-132.
[25] 张瑞娥. 经纤维支气管镜局部给药对耐多药肺结核病的治疗研究[J]. 中国防痨杂志, 2002, 4(1):16-18.
[26] Mitnick, C.D., McGee, B. and Peloquin, C.A. (2009) Tuberculosis Pharmacotherapy: Strategies to Optimize Patient Care. Expert Opinion on Pharmacotherapy, 10, 381-401. [Google Scholar] [CrossRef] [PubMed]