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目的评价含环丝氨酸(Cs)的标准方案治疗耐多药肺结核过程中出现严重精神症状的发生情况,为环丝氨酸在耐多药肺结核治疗的临床应用提供参考依据。方法回顾性分析2012年6月1日—2014年6月30日武汉市结核病防治所全球基金耐多药肺结核项目采用含有环丝氨酸标准化治疗方案的113例患者,对其中6例出现严重精神症状的病例进行临床分析。结果 113例耐多药肺结核中6例出现严重精神症状(占5.3%),出现严重精神症状后均停用环丝氨酸,经药物干预后症状缓解,后续治疗予PAS替代,均未再使用环丝氨酸。结论环丝氨酸是较安全的治疗耐多药肺结核的二线抗结核药物,环丝氨酸的不良反应主要是精神症状,出现严重精神症状需及时停药,药物干预,精神症状能在短期内缓解。
Objective To evaluate the occurrence of serious psychiatric symptoms during the treatment of multidrug-resistant pulmonary tuberculosis (TBM) with standard regimen containing Cs, and to provide a reference for the clinical application of CS on MDR-TB treatment. Methods Retrospective analysis from June 1, 2012 to June 30, 2014 The Wuhan TB Trust Fund Global Fund for MDR-TB Treatment of 113 patients with standardized regimens containing cyclosporine, 6 of whom had severe psychiatric symptoms Case for clinical analysis. Results Sixty-three of 113 MDR-TB cases showed severe psychiatric symptoms (accounting for 5.3%). All patients with severe psychiatric symptoms were stopped using cycloserine. After treatment, the symptoms were relieved and the follow-up treatment was given to PAS instead of using cyclic serine . Conclusion Cyclosporine is a safe second-line anti-TB drug for the treatment of MDR-TB. The adverse reactions of cycloserine are mainly psychiatric symptoms. Serious mental symptoms need to be stopped in time. Drug intervention and mental symptoms can be relieved in a short period of time.