http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
- 中文 을 입력하시려면 zhongwen을 입력하시고 space를누르시면됩니다.
- 北京 을 입력하시려면 beijing을 입력하시고 space를 누르시면 됩니다.
RISS 인기검색어
- 검색키워드
- 주제어 : Antituberculous agents (검색결과 2 건)
- 무료
- 기관 내 무료
- 유료
-
천우정,최석진,정호근,최우혁,구정태,김성자,김수성,이영현 東國大學校醫學硏究所 2001 東國醫學 Vol.8 No.-
연구 목적 : 1952년 streptomycin보다 더 강력한 약제인 isoniazid가 개발되면서부터 본격적으로 결핵에 대한 화학 요법이 시작되었다. 최근 들어서는 결핵이 개발 도상국에서의 약제내성과 치료 실패의 증가과 선진국에서의 후천성 면역 결핍 증후군의 증가로 인해 다시 전세계적으로 큰 문제가 되고 있다. 결핵은 그 원인균의 특성으로 인해 잦은 내성균 출현 및 흔한 재발로 적어도 3가지 이상의 다제 병합요법이 필요하다. 특히, isoniazid와 rifampicin을 포함한 단기 요법은 결핵 치료에 있어서 매우 효과적인 치료법으로 증명되었으나 간독성 잇는 약제끼리의 병합 투여로 인한 간독성이 문제가 되며, 간독성이 나타난 경우에 어떤 약제에 의한 것인지 설명하기 어려운 경우가 많다. 이에 저자들은 최근 6년간 동국대 병원에 입원하여 항결핵제에 의한 간독성을 보인 환자들의 임상상을 조사하였다. 연구 밥법 : 1994년 1월부터 1999년 2월까지 동국대병원에 입원하여 isoniazid, rifampin, pyrazinamide 병합요법으로 치료하던중 간독성을 일으킨 환자 22예를 대상으로 후향적으로 관찰하였다. 연구 결과 : 1) 증상이 없이 간독성이 발견된 예가 8예(36%)였다. 2) 혈청 총 빌리루빈치가 1.0mg/dl 이하인 경우가 14예(64%)이었다. 3) 항결핵제 투여후 간기능 이상이 발견된 시기는 평균 31일로서 2주 이내가 11예(50%), 2주에서 4주사이가 5예(22%)로 대부분 4주 이내였다. 4) 항결핵제 투여 중지 후 모든 예에서 간기능이 정상으로 호전되었으며, 호전되기까지 걸린 기간은 평균 16일이었고, 20예(90%)가 4주이내였다. 5) 항결핵제 재투여는 isoniazid 20예중 15예(75%), rifampicin 20예중 17예(85%), pyrazinamide 13예중 10예(77%)에서 가능하였다. 결론 : 항결핵제 투여후 처음 4주간은 증상이 없더라도 매주 간기능 검사를 하는 것이 좋을 것으로 사료되고, 간독성을 일으킨 항결핵제라도 신중하게 소량씩 증량하면 재투여가 가능하리라고 생각된다. Objectives : In 1952, the remarkable activity of isoniazid upstaged the role of streptomycin, establishing this new bactericidal agent as the principal drug in the battle against Mycobacterium tuberculosis. Tuberculosis continues to be a major health problem in both the developing and developed countries because of its resurgence in immunosuppressed patients. As a consequence of the development of multiple drug resistance, frequent recurrence, combinations of three or more major antituberculous agents are often prescribed in patients with active tuberculosis. Especially, Short course chemotherapy containing rifampicin and isoniazid in combination has proved to be highly effective in the teratment of tuberculosis, but one of its adverse effects is hepatotoxicity. Adverse effects attributed to anituberculosis therapy are not always the result of single agent, but are sometimes potentiated by multiple-drug regimens. Method : From January 1994-Feburary 1999, twenty two patients in whom there was clinical or biochemical evidence of liver damage during combination antituberculous therapy of isoniazid and rifampin with pyrazinamide were studied. Results : 1) Eight patients(36%) were entirely asymptomatic at the time of detecting hepatotoxicity. 2) In fourteen patients (64%), the maximum serum bilirubin levels were below 1.0mg per 100ml. 3) The mean time presenting clinical hepatotoxicity during antituberculous therapy was 31 days, 11 patients (50%) were below 2 weeks and 16 patients(72%) were below 4 weeks. 4) The mean time normalizing liver function after hepatotoxic drugs withdrawal is 16 days, and 20 patients (90%) were below 4 weeks. 5) Readministrations of isoniazid, rifampin and pyrazinamide were successful in 75%, 85% and 77% of the patients. Conclusion : Weekly biochemical monitoring should be done routinely in patients receiving antituberculous therapy to avoid the development of hepatotoxicity. However, in most cases, it is possible to readminister the antituberculous drugs from small dosages without hepatotoxicity.
-
심낭 삼출액 환자에서 Adenosine Deaminase를 근거로 한 항결핵 치료 결정의 적합성
김나영 ( Na Young Kim ),민지현 ( Ji Hyun Min ),안종화 ( Jong Hwa Ahn ),조상영 ( Sang Young Cho ),이은주 ( Eun Ju Lee ),황석재 ( Seok Jae Hwang ),박용휘 ( Yong Whi Park ),곽충환 ( Choong Hwan Kwak ),황진용 ( Jin Yong Hwang ),박정랑 대한내과학회 2012 대한내과학회지 Vol.82 No.4
Background/Aims: The prognostic impact of empirical anti-tuberculous management according to adenosine deaminase (ADA) levels in patients exhibiting pericardial effusion (PE) has not been established. We evaluated the appropriateness of ADA-guided anti-tuberculous medication for patients with PE. Methods: From 2001 to 2010, 47 patients with PE and who were diagnosed with either tuberculous pericarditis (TbP) or idiopathic pericarditis (IP) were enrolled. The diagnosis of definite TbP was made by the presence of Tb bacilli or caseous granuloma in pericardial tissue or effusion. The diagnosis of probable TbP was made by the presence of one or more of the following: (1) elevated ADA (≥ 40 IU/L) in pericardial fluid, (2) positive Tb interferon test, or (3) extracardiac presence of Tb. All clinical information was collected by medical record review and telephone contact. Results: Among the 47 patients with PE, 12 were diagnosed with definite TbP; 17, with probable TbP; and 18, with IP. The mean ADA level was significantly higher in patients with definite TbP than in patients with IP (74.97 ± 36.79 vs. 20.14 ± 7.39 IU/L; p < 0.001). The optimal ADA cutoff value for diagnosis of definite TbP was 64 IU/L. The median follow-up time was 12.1 months (range, 0.17-100 months). In patients with low levels of ADA (< 40 IU/L), the incidence of death or recurrence did not different between patients who were prescribed anti-tuberculous medication and those who were not. Conclusions: The ADA level in pericardial fluid was useful for making a rapid diagnosis of tuberculous pericarditis. Even in tuberculosis-endemic areas, patients with ADA < 40 IU/L may have a good prognosis without empirical anti-tuberculous treatment. (Korean J Med 2012;82:441-448)
KISS연관 검색어 추천
이 검색어로 많이 본 자료
활용도 높은 자료
