じん肺の現状と合併結核の化学療法

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Some problems regarding the chemotherapy for silico-tuberculosis, which has long been understood as an entirely distinct clinical entity since 1930s, were studied and discussed. The main subjects were whether or not the contemporary chemotherapy composing of RFP, INH and others is able to attain the curative results and to shorten the duration of treatment in silico-tuberculosis as in pulmonary tuberculosis not complicating silicosis.<BR>Conclusively speaking, significantly better results were obtained by regimens containing RFP and INH as compared with the results by any other past chemotherapy regimens in cases of original treatment and even in re-treatment. When compared with the results in cases with pulmonary tuberculosis alone, however, the results in silico-tuberculosis seems to be remarkably inferior and this results prevent us to shorten the duration of chemother apy. Some notable findings of this study were as follows; 1) the rate of culture negative conversion was not more than 93.0 per cent, even among cases of original treatment, 2) despite of the fact that 79.1% of original treatment cases converted to negative by culture within 6 months, there were some cases who finally needed much longer term of treatment, e. g. 15 months and 33 months, 3) the rate of bacteriological relapses in original treatment cases was 5% which is higher than the rate in cases with pulmonary tuberculosis alone treated by intensive regimens.<BR>Discussing exclusively on the "combination form" of silico-tuberculosis, the results obtained in this study seemed to suggest strongly that the recent intensive chemotherapy could not show a complete sterilizing effect on the persisters in the lesions due to their very peculiar histological structure, such as silico-tuberculous nodule or massive fibrosis. On the other hand, authors believe that confining cases of tuberculosis complicated with the majority of pneumoconiosis other than silicosis and even with silicosis, in wihch the lesions are merely "complication form", no particular modification of the standardized intensive chemotherapy for tuberculosis is needed.
一般社団法人日本結核病学会の論文

じん肺の現状と合併結核の化学療法

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