ABSTRACT
To evaluate the clinical efficacy and safety of short-course chemotherapy combined with regional injection therapy in the treatment of superficial lymph node tuberculosis. 201 patients diagnosed with superficial lymph node tuberculosis were retrospectively analyzed. All patients were randomly divided into the study (n = 100) and control groups (n = 101). In the study group, the patients received 6-month chemotherapy with isoniazid (H), rifampin (R) and ethambutol (E) (6HRE) in combination with regional injection of streptomycin, and their counterparts in the control group underwent systemic regime of 3HRZE/6HRE. In the study group, the overall cure rate was calculated as 98% and the recurrence rate was 2%. Twenty-four of 25 nodular type patients and 36 among 37 inflammatory type patients were recovered and discharged. One patient with huge nodular type mass was treated for 4 months and the mass size was slightly reduced. In the control group, the overall cure rate was 48.5% and the recurrence rate was 7.9%. The recurrent patients were further administered with regional injection of streptomycin based upon the chemotherapy regime until they were recovered. Combined therapy of systemic chemotherapy and regional injection of streptomycin is probably an efficacious and safe approach in the treatment of superficial lymph node tuberculosis, which remains to be validated by more investigations.
ABSTRACT
OBJECTIVE: To observe the relationship between the genetic polymorphism of P450-2E1 and the risk for antituberculosis drug-induced hepatotoxicity in a Chinese population. METHODS: Blood samples and clinical data were collected from 85 patients with antituberculosis drug-induced hepatotoxicity and 100 tuberculosis patients without hepatotoxicity as the control. DNA was extracted from the blood samples, and the frequencies of P450-2E1 RsaI genotypes were analyzed using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). The relationship between the polymorphisms of P450-2E1 RsaI and the antituberculosis drug-induced hepatotoxicity was analyzed. Predisposing factors for antituberculosis drug-induced hepatitis, such as gender, age, and polymorphism of P450-2E1 RsaI were evaluated by using logistic regression analysis. RESULTS: The frequencies of the 3 gene types P450-2E1 RsaI c1/c1, c1/c2, and c2/c2 were 75% (64/85), 20% (17/85) and 5% (4/85) respectively in patients with antituberculosis drug-induced hepatotoxicity, and 61% (61/100), 30% (30/100), and 9% (9/100) respectively in the controls. A statistical difference was found between the cases and the controls (chi(2) = 4.284, P < 0.05, OR = 2.016, 95%CI = 1.058 - 3.842). Logistic regression analysis showed that the polymorphism of P450-2E1 RsaI remained a significant independent risk factor for antituberculosis drug-induced hepatotoxicity after adjustment for age, gender and body mass index. CONCLUSION: Polymorphisms of P450-2E1 were found to be significantly associated with the risk of antituberculosis drug-induced hepatotoxicity, and the c1/c1 genotype was one of the risk factors.
