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相關文獻
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| 題 名 | Pattern of Defervescence in Response to Anti-Tuberculosis Therapy in Patients with Extrapulmonary Tuberculosis and Advanced Human Immunodeficiency Virus Infection=在末期後天免疫不全病毒感染和肺外結核者使用抗結核藥物後退燒型態的分析 |
|---|---|
| 作 者 | 謝思民; 盛望徽; 陳茂源; 洪健清; | 書刊名 | 臺灣醫學會雜誌 |
| 卷 期 | 98:8 1999.08[民88.08] |
| 頁 次 | 頁550-555 |
| 分類號 | 415.69、415.69 |
| 關鍵詞 | 後天免疫不全病毒感染; 肺外結核; 抗結核藥物; 退燒; Human immunodeficiency virus; Acquired immunodeficiency syndrome; Tuberculosis; Disseminated mycobacterium avium complex; Antimycobacterial therapy; Fever response; |
| 語 文 | 英文(English) |
| 英文摘要 | The pattern of fever response to empiric anti-tuberculosis therapy in patients with tuberculosis (TB) and human immunodeficiency virus (HIV) infection, and the relationship between fever response patterns and anti-TB drug susceptibility profiles of Mycobacterium tuberculosis isolates are rarely described. In this study, we evaluated the fever responses to a four-drug anti-TB regimen in 26 HIV-infected patients with culture-proven extrapulmonary TB, and compared the results with those in 12 patients with disseminated Mycobacterium avium complex (DMAC) infection treated with a clarithromycin-containing regimen. The CD4 lymphocyte counts did not differ significantly between TB and DMAC patients (26×10□/L in TB patients vs 5×10□ /L in DMAC patients). Drug susceptibility data were available for 22 patients with TB. Most TB patients had rapid defervescence after initiation of anti-TB therapy. Fever resolved within 1 week in 85% (22/26) of patients, including three of six (50%) with multidrug-resistant (MDR) TB. The median duration of fever in patients with drug-susceptible TB was similar to that in patients with drug-resistant TB (3 vs 4 days, p=0.33). However, patients with MDR-TB were more likely than those with non-MDR TB to have fevers lasting longer than 1 week after initiating anti-TB therapy (3/6 vs 1/16, p=0.146). Only 17% (2/12) of the patients with DMAC infection became afebrile within 1 week of beginning anti-MAC therapy (p<0.001 vs those with TB). Our observations suggest that in HIV-infected patients with advanced immunosuppression, anti-TB regimens achieve significantly faster defervescence in TB patients than do anti-MAC regimens in DMAC patients. Rapid defervescence in patients with TB does not necessarily indicate that TB isolates are not MDR strains. |
本系統中英文摘要資訊取自各篇刊載內容。