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目的探讨肝硬化合并初治涂阳肺结核的治疗方案。方法将76例符合标准的肝硬化合并初治涂阳肺结核患者随机分为观察组和对照组,分别采用3HSEM/9HEM方案和3HSE/9HE方案,观察两组方案的临床疗效对肝功能的影响。结果 1观察组3、6、9、12个月痰菌阴转率分别为47.5%、77.5%、87.5%、92.5%,对照组为28.6%、54.3%、65.7%、74.3%,观察组痰菌阴转率明显高于对照组(P<0.05)。2治疗12个月后,观察组病灶吸收率为85.0%,明显高于对照组的65.7%(P<0.05)。3与治疗前比较,两组治疗后丙氨酸氨基转移酶、总胆红素及白蛋白均有所好转(P<0.05)。结论 3HSEM/9HEM方案治疗肝炎肝硬化合并初治涂阳肺结核不仅抗结核效果好,而且对肝功能影响较小。
Objective To investigate the treatment of hepatocirrhosis with smear-positive pulmonary tuberculosis. Methods Seventy-six patients with cirrhosis and untreated smear-positive pulmonary tuberculosis were randomly divided into observation group and control group. The 3HSEM / 9HEM and 3HSE / 9HE regimens were used respectively to observe the effect of the two groups on the liver function. Results 1 The sputum negative conversion rates in the observation group were 47.5%, 77.5%, 87.5% and 92.5% at 3, 6, 9 and 12 months respectively, while those in the control group were 28.6%, 54.3%, 65.7% and 74.3% The negative rate of bacteria was significantly higher than that of the control group (P <0.05). 2 After 12 months, the absorption rate of the observation group was 85.0%, which was significantly higher than that of the control group (65.7%, P <0.05). 3 Compared with before treatment, the alanine aminotransferase, total bilirubin and albumin in both groups improved (P <0.05). Conclusion 3HSEM / 9HEM treatment of hepatitis cirrhosis with naive smear-positive pulmonary tuberculosis not only has good antituberculous effect, but also has little effect on liver function.