1、第第 45 章章Anti-tuberculosis and anti-leprosy drugs1【目的要求】 1、掌握抗结核病药异烟肼、利福平、乙胺丁醇、对氨水杨酸、链霉素的抗结核作用特点、用途和不良反应；2、 掌握抗结核药的用药原则。2结核n 结核俗称 “ 痨病 ” ，它和人类的历史几乎一样长。它曾在全世界广泛流行，夺去了数亿人的生命，人们称之为白色瘟疫。n 结核病是由结核杆菌引起的慢性传染病，可累及全身多个器官，但以肺结核最为常见。结核病临床上多呈慢性过程，少数可急起发病。常有低热、乏力等全身症状和咳嗽、咯血等呼吸系统表现。 34The bacillus causing tubercul
2、osis, Mycobacterium tuberculosis, was identified and described on 24 March 1882 by Robert Koch.5第一节第一节 第第 1线线 抗结核病药抗结核病药First-line anti-TB drugsl 我国现有结核病人 600万 左右；l 每年死亡人数 25万 左右；l WHO估计全球每年发病人数约 800万 人；l 特别是 HIV高发地区 TB发病率高。6n “ 制止结核病 ” 世界行动组织公布的数字显示，目前全球每天仍有五千人死于结核病，而每年患结核病的人数超过八百万。n 一个重要的原因是结核菌逐步发
3、展出来的多种药物抗药性（ MDR-TB）有使目前的抗结核菌药物失效的危险。产生抗药性的主要原因和产生抗生素的抗药性类似。n 目前的抗结核药物通常都需要连续服用六到八个月，而许多患者都不能完成整个疗程，使病菌在低剂量的药物处理下把抗药性的剑越磨越利。7Epidemiologyn Roughly one-third of the worlds population has been infected with M. tuberculosis, with new infections occurring in about 1% of the population each year.n Howeve
4、r, most infections with M. tuberculosis do not cause TB disease, and 9095% of infections remain asymptomatic.n In 2012, an estimated 8.6 million chronic cases were active. In 2010, 8.8 million new cases of TB were diagnosed, and 1.201.45 million deaths occurred, most of these occurring in developing countries. Of these 1.45 million deaths, about 0.35 million occur in those also infected with HIV.8Chest X-ray of a person with advanced tuberculosis9抗结核病药抗结核病药（ Anti-tuberculosis）第一线药： 异烟肼利福平乙胺丁醇链霉素吡嗪酰胺10
