肺結核外来化学療法の効果と近接成績 第4報

抄録

In the previous reports, the authors made analysis on the factors influencing the results of chemotherapy and came to the following conclusion;
1) radiological improvement was different by age, the type of pulmonary lesion, the regimen of chemotherapy and the presence of previous chemotherapy.
2) radiological aggravation after the cessation of chemotherapy was different by age, the maximal size and the type of lesion.
In the present report, the authors made further analysis on the factors influencing radiological improvement during chemotherapy and aggravation after the cessation of chemotherapy on 2902 cases of pulmonary tuberculosis conducted at out-patient clinics of Japan Antituberculosis Association. Among 2902 cases, 2117 were original treatment cases and 785 were retreatment cases, and the follow-up period after the cessation of chemotherapy was the following; 0-1 year 619, 1.1-2 years 683, 2.1-3years 561, 3.1-5 years 759 and longer than 5 years 280.
When analysis was made on one factor, comparison was made among cases with the same back ground factors regarding other factors. The results were the following:
Among original treatment cases.
1) Comparing radiological improvement by the regimen of chemotherapy, no significant difference was found between SM INH. PAS group and INH. PAS group both in cases with infiltrative caseous type lesion (B type) and that with intermediate type between infiltrative caseous and fibrocaseous typelesions (CB type).
2) No significant difference was found in radiological aggravation after the cessation of chemotherapy between SM INH PAS group and INH. PAS group.
3) Radiological aggravation after the cessation of chemotherapy was significantly higher among cases treated for less than 1 year than among cases, treated for 1 year or longer. Among retreatment cases.
1) Regarding rad iological improvement during: chemotherapy.
a) Observing by the type of pulmonary lesion at the beginning of treatment, the rate wash igher among B type lesion than among CB type lesion.
b) No significant difference was found by the extent of lesions, and the regimen of chemotherapy.
c) Comparing by the exercise status during chemotherapy, no significant differnce was found between cases continued on work and cases kept. bed rest. d) Comparing by age, the rate was higher among oases younger than 30 years or over.
2) Regarding radiological aggravation after the cessation of chemotherapy.
a) Observing by the type of lesions at the end of treatment, the rate was higher among cases with CB type lesion than among cases with fibrocaseoustype lesion (CC type).
b) The rate was higher among cases younger than 30 years than among cases 30 years or over.
c) Comparing by the duration of chemotherapy, the rate was higher among cases treated for less than 18 months.
d) Comparing by the maximal size of lesion at the end of treatment, the rate was higher among cases with lesions less than 1 cm.
e) No significant difference was found by the regimen of chemotherapy.
3) No significant difference was found in radioogical. aggravation after the cessation of chemothepapy by original treatment cases and retreatment cases.