Effect of Chemotherapy on Pulmonary Tuberculosis of the Aged
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概要
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This study was planned to decide whether or not the effect of chemotherapy on pulmonary tuberculosis of the aged is inferior to that in young adults and to elucidate the cause in case there is such a difference.Among patients admitted to this hospital for initial treatment from January 1962 to February 1971, 75 aged patients with pulmonary tuberculosis over the age of 60 and 389 young adults patients below the age of 39 with the same disease were compared as to the results of 12 months treatment with combination of SM, INH and PAS.Results:1) Two groups were compared as to the chest x-ray findings, positive or negative tubercle bacilli in the sputa, and amount of bacilli in the sputa at the time of detection or beginning of initial treatment. While no difference was found in the positive or negative bacilli in the sputa and amount of bacilli in the sputa, chest x-ray findings definitely showed the predominance of old lesions resistant to chemotherapy in the aged.2) Comparison of the effect of 12 months treatment with SM, INH and PAS revealed no difference in the rate of change of bacilli in the sputa to negativity. Rate of improvement of fundamental disease type and closure of cavity, however, was definitely inferior in the aged. This is apparently related to the predominance of cases resistant to chemotherapy among the aged subjects before treatment.3) Cases with as much resemblance as possible as to the conditions before treatment were therefore selected from each group in a so-called matched pair system, to compare the result of chemotherapy. No difference was then detected between the two groups and aged patients responded as the young adults.4) The true onset was presumed based on the past history on respiratory system and others. In the aged, true onset was frequently old and a delay of detection was rather conspicuous.These results would suggest that pulmonary tuberculosis of the aged appears to be resistant to chemotherapy because many patients in this age group are already in the stage with poor response to chemotherapy, due to the delay in the detection and treatment as one of the main causes.
- 一般社団法人 国立医療学会の論文
一般社団法人 国立医療学会 | 論文
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