摘要目的 观察和评价母牛分枝杆菌菌苗(微卡)在治疗耐多药结核病病中的效果.方法 随机将58例耐多药肺结核患者分为治疗组(29例)和对照组(29例).根据患者既往用药史及药敏报告,选择未使用药物及敏感药物组合化疗方案.2组均采用统一结核病化疗方案:3LivTHAK/15LivTH,治疗组肌肉注射母牛分枝杆菌菌苗22.5 μg,强化期每10天1次,继续治疗期前3个月,15 d/次,后12个月,1月/次,共用21次.对照组不用母牛分枝杆菌菌苗.观察2组痰菌阴转、病灶吸收、空洞闭合情况.结果 治疗3、6、9、18个月术痰菌阴转率治疗组为58.6%、68.9%、82.7%、96.6%;对照组为31.0%、41.3%、55.2%、72.4%(P＜0.05);疗程结束时治疗组和对照绀胸部X线病灶吸收率分别为93.1%和68.9%(P＜0.05);空洞闭合率分别为92.6%和65.4%(P＜0.05).随访治疗组无1例复发,对照组的细菌复发率为9.5%(P＞0.05).结论 母牛分枝杆菌菌苗联合其他化疗药物治疗耐多药结核病,能加快痰菌转阴、病灶吸收和空洞闭合的速度,随访一年无1例复发,不良反应少且较轻微.母牛分枝杆菌菌苗是非常有效的耐多药肺结核患者免疫治疗剂.

abstractsObjective To observe and evaluate the mycobacterium vaccae vaccine(micro-card) in the treatment of MDR-TB disease.Methods 58 cases of MDR-TB patients were randomly divided into treatment group (29 cages) and the control group(29 cases).According to the patients in the past history of drug use and drug-sensitivity of the report.Chose not to use drugs and drug combinations sensitive to chemotherapy.The two groups were unified tuberculosis chemotherapy:3LivTHAK/15LivTH,intramuscular injection in the treatment group mycobacterium vaccae vaccine 22.5 μg,strengthen the 10 days period for each 1.To continue the treatment period,the first 3 months,15 days,After 12 months once a month,a total of 21 times.The control group did not have to mycobacterium vaccae vaccine.To observe the situation of two group of sputum conversion,lesions absorption,pore closure.Results 3,6,9,18 months treatment,sputum conversion rate of group therapy were 58.6%、68.9%、82.7%、96.6%;the control group were 31.0%、41.3%、55.2%、72.4%(P＜0.05).The pore closure rate of two group were 92.6% and 65.4%(P＜0.05).At the end of treatment,the treatment group and control group,lesions in the chest X-ray absorption rate were 93.1% and 68.9% (P＜0.05).There was no follow-up treatment of 1 case of relapse,the control group of bacteria recurrence rate was 7.7% (P＞0.05).Conclusion Mycobacterium vaccine in conjunction with other chemotherapy drugs MDR-TB,can accelerate the speed of the negative sputum,Focus absorption and pore closure.Year relapse-free follow-up case,fewer side effects or minor.Mycobacterium vaccae vaccine is very effective multi-drug of resistant tuberculosis patients in the treatment of immune agent.