结核病治疗的最新情况

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摘要

结核病(TB)每年影响着 1 000 多万人。与其他传染病相比,结核病的治疗发展缓慢,而我们却在与这一负担作斗争。本综述旨在向医护人员介绍结核病治疗的最新进展。40 多年前确立的药物组合仍然足以治愈大多数结核病患者。然而,随着基于利福平和异烟肼(仅)6 个月治疗方案的普及,耐药性出现了。耐药病例需要使用注射药物进行长期治疗。现在,经过令人振奋的十年研究,我们可以使用基于贝达喹啉、硝基咪唑类和利奈唑胺的口服方案治疗耐药结核病,疗程(仅)为 6 个月,而且我们可能很快就会突破 6 个月疗程的障碍。然而,如果没有患者及其社区的参与,实现坚持治疗、传播控制和改善健康的社会经济决定因素,这些改进还不足以终结结核病。
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Update on the treatment of tuberculosis

Tuberculosis (TB) affects more than 10 million people each year. We have contested this burden with a paradoxically slow development of treatments, as compared to other infectious diseases. This review aims to update health care professionals on the last developments for the management of TB. The combination of drugs established more than 40 years ago is still adequate to cure most people affected by TB. However, with the generalisation of regimens based on rifampicin and isoniazid for (only) 6 months, resistance emerged. Resistant cases needed long tratments based on injectable drugs. Now, after an exciting decade of research, we can treat resistant TB with oral regimens based on bedaquiline, nitroimidazoles, and linezolid for (only) 6 months, and we may soon break the 6-month barrier for treatment duration. However, these improvements are not enough to end TB without an engagement of people affected and their communities to achieve adherence to treatment, transmission control, and improve socioeconomic determinants of health.

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