{"id":726,"date":"2016-05-02T09:19:20","date_gmt":"2016-05-02T01:19:20","guid":{"rendered":"http:\/\/epaper.pch.org.tw\/?p=726"},"modified":"2016-05-02T11:53:48","modified_gmt":"2016-05-02T03:53:48","slug":"%e6%bd%9b%e4%bc%8f%e7%b5%90%e6%a0%b8%e6%84%9f%e6%9f%93%e6%9c%80%e6%96%b0%e7%99%82%e6%b3%95","status":"publish","type":"post","link":"http:\/\/epaper.pch.org.tw\/?p=726","title":{"rendered":"\u6f5b\u4f0f\u7d50\u6838\u611f\u67d3\u6700\u65b0\u7642\u6cd5"},"content":{"rendered":"

\u25a0 \u611f\u67d3\u79d1\u4e3b\u4efb \u8521\u6587\u77f3 \u91ab\u5e2b<\/p>\n

\u7d50\u6838\u75c5\u662f\u76ee\u524d\u570b\u5167\u6700\u591a\u7684\u6cd5\u5b9a\u50b3\u67d3\u75c5\uff0c10\u5e74\u524d\u570b\u5167\u7d50\u6838\u75c5\u4eba\u4e00\u5e74\u7d04\u6709\u65b0\u6848\u4e00\u842c\u516d\u5343\u4eba(10\u842c\u4eba\u6709 72.5\u4eba)\uff0c\u7d93\u653f\u5e9c\u9019\u5e7e\u5e74\u4f86\u52aa\u529b\u76ee\u524d\u5df2\u4e0b\u964d\u5230\u4e00\u5e74\u7d04\u6709\u4e00\u842c\u4e00\u5343\u4eba(10\u842c\u4eba\u670940\u591a\u4eba)\uff0c\u4f46\u4ecd\u662f\u6240\u6709\u6cd5\u5b9a\u50b3\u67d3\u75c5\u6700\u591a\u8005.\u7d50\u6838\u75c5\u60a3\u8005\u5982\u4e0d\u6cbb\u7642\u4e00\u5e74\u7d04\u53ef\u50b3\u67d312\u81f314\u4eba\uff0c\u7136\u800c\u7d50\u6838\u75c5\u60a3\u8005\u75c7\u72c0\u4e0d\u660e\u986f\uff0c\u5076\u6709\u54b3\u55fd\uff0c\u767c\u71d2\uff0c\u98df\u617e\u4e0d\u632f\uff0c\u9ad4\u91cd\u6e1b\u8f15\uff0c\u4e0d\u6613\u65e9\u671f\u767c\u73fe\u6545\u8981\u6839\u7d55\u7d50\u6838\u75c5\u5be6\u5c6c\u4e0d\u6613\u3002
\n\u653f\u5e9c\u5728\u901910\u5e74\u9593\u70ba\u7d50\u6838\u75c5\u7684\u9632\u5236\u6295\u6ce8\u4e86\u8a31\u591a\u5fc3\u8840\uff0c\u7531\u6c11\u570b95\u5e74\u63a8\u52d5DOTS\u6cbb\u7642(Direct observation therapy short course)\uff0c\u7531\u89c0\u61f7\u54e1\u6bcf\u65e5\u76ee\u8996\u60a3\u8005\u670d\u85e5\u81f3\u5b8c\u6210\u6cbb\u7642\uff0c96\u5e74\u6210\u7acb\u591a\u91cd\u6297\u85e5\u6027\u80ba\u7d50\u6838\u5c08\u696d\u6cbb\u7642\u5718\u968a\uff0c97\u5e74\u958b\u59cb\u63a8\u52d5\u521d\u4e2d\u4ee5\u4e0b(<13\u6b72)\u6f5b\u4f0f\u6027\u80ba\u7d50\u6838\u6cbb\u7642\uff0c\u6b77\u7d93\u7d048\u5e74\u6642\u9593\u5c07\u63a5\u89f8\u8005\u9010\u6b65\u64f4\u5927\uff0c\u8a66\u8fa6\u5730\u5340\u5ef6\u4f38\uff0c\u8a3a\u65b7\u529f\u5177\u7cbe\u9032\u65bc\u4eca\u5e74\u63a8\u51fa\u300c\u901f\u514b\u4f0f\u300d\u77ed\u7a0b\u6cbb\u7642\u8655\u65b9\u4f9b\u91ab\u7642\u4e0a\u8a3a\u6cbb\u6f5b\u4f0f\u7d50\u6838\u611f\u67d3\u4e4b\u9078\u64c7\uff0c\u5e95\u4e0b\u5c31\u653f\u5e9c\u516c\u7248\u6587\u4ef6\u63d0\u51fa\u8aaa\u660e\u5982\u4e0b\uff1a
\n\u4f7f\u7528\u300c\u901f\u514b\u4f0f\u300d\u6cbb\u7642\u6f5b\u4f0f\u7d50\u6838\u611f\u67d3\u6cbb\u7642\u81e8\u5e8a\u5efa\u8b70
\n\u653f\u7b56\u8aaa\u660e<\/strong>
\n\u75be\u75c5\u7ba1\u5236\u7f72\u53c3\u8003\u4e16\u754c\u885b\u751f\u7d44\u7e54\u53ca\u7f8e\u570bCenters for disease control (CDC)\u5c0d\u65bc\u6f5b\u4f0f\u7d50\u6838\u611f\u67d3(latent TB infection\uff0c LTBI) \u8655\u7f6e\u7684\u5efa\u8b70\uff0c\u65bc2016\u5e743\u67081\u65e5\u8d77\u5168\u9762\u4ee5\u8840\u6db2\u7d50\u6838\u4e19\u578b\u5e72\u64fe\u7d20(interferon gamma release assay\uff0c IGRA) \u505a\u70ba5\u6b72\u4ee5\u4e0a\u7d50\u6838\u75c5\u63a5\u89f8\u8005LTBI\u8a3a\u65b7\u5de5\u5177\uff0c\u4e26\u65bc4\u67081\u65e5\u8d77\u589e\u52a0\u63d0\u4f9b\u300c\u901f\u514b\u4f0f\u300d\u77ed\u7a0b\u6cbb\u7642\u8655\u65b9\u4f9b\u91ab\u7642\u4e0a\u8a3a\u6cbb\u6f5b\u4f0f\u7d50\u6838\u611f\u67d3\u4e4b\u9078\u64c7\uff0c\u5e0c\u671b\u900f\u904e\u6b64\u6cbb\u7642\u671f\u7a0b\u8f03\u77ed\u3001\u8f03\u5c11\u809d\u708e\u526f\u4f5c\u7528\u7684\u65b0\u8655\u65b9\u9078\u64c7\uff0c\u5354\u52a9\u50b3\u67d3\u6027\u80ba\u7d50\u6838\u75c5\u4e4b\u5168\u5e74\u9f61\u5c64\u63a5\u89f8\u8005\uff0c\u90fd\u80fd\u7d93\u904e\u6aa2\u9a57\u63a5\u53d7\u6cbb\u7642\uff0c\u4ee5\u6e1b\u5c11\u63a5\u89f8\u8005\u672a\u4f86\u7684\u767c\u75c5\u3002\u300c\u901f\u514b\u4f0f\u300d\u8655\u65b9\u7531\u65bc\u50c5\u670912\u6b21\uff0c\u6545\u9078\u7528\u6b64\u985e\u8655\u65b9\u7684\u6f5b\u4f0f\u611f\u67d3\u8005\uff0c\u5747\u9700\u4f9d\u898f\u5b9a\u642d\u914d\u90fd\u6cbb\u95dc\u61f7\u9001\u85e5\uff0c\u78ba\u4fdd\u6bcf\u4e00\u500b\u85e5\u5291\u90fd\u6709\u88ab\u6f5b\u4f0f\u611f\u67d3\u8005\u670d\u7528\u3002\u4ee5\u4e0b\u91dd\u5c0d\u65b0\u589e\u52a0\u8655\u65b9\u9078\u64c7\u300c\u901f\u514b\u4f0f\u300d\u5728\u4f7f\u7528\u4e0a\uff0c\u91ab\u7642\u8655\u7f6e\u548c\u526f\u4f5c\u7528\u76e3\u6e2c\u4e4b\u5efa\u8b70\uff0c\u9032\u884c\u8aaa\u660e\u3002
\n\u300c\u901f\u514b\u4f0f\u300d\u8207\u50b3\u7d71\u6cbb\u7642\u76f8\u540c\u6cbb\u7642\u6548\u679c\u4e14\u6709\u8f03\u9ad8\u5b8c\u6210\u7387
\n\u9664\u4e86\u73fe\u884c9\u500b\u6708daily isoniazid(INH) \u8655\u65b9\uff089H\uff09\uff0c\u75be\u75c5\u7ba1\u5236\u7f72\u4ea6\u63a8\u85a6\u7684\u65b0\u9078\u64c7\u300c\u901f\u514b\u4f0f\u300d\u662f\u4e00\u500b\uff0c\u4e00\u9031\u4e00\u6b21\uff0c12\u500b\u5291\u91cf\u4e4b\u77ed\u7a0b\u6cbb\u7642\u8655\u65b9\uff0c\u5176\u7d44\u6210\u7684\u85e5\u7269\u70baINH 900mg\u5408\u4f75rifapentine(RPT) 900mg\uff0c\u7c21\u7a313HP\u3002\u9019\u500b\u65b0\u7684\u8655\u65b9\u9078\u64c7\uff0c\u572850\u516c\u65a4\u7684\u6210\u4eba\uff0c\u5be6\u969b\u4f7f\u7528\u7684\u85e5\u7269\u70ba\uff1aINH (300mg)3# + RPT (150mg)6#\uff0c\u4e00\u5171\u662f9\u9846\u4e00\u6b21\u670d\u7528\u30023HP\u5728\u570b\u5916\u7684\u6587\u737b\u53ca\u570b\u5167\u7d04200 \u4eba\u7684\u81e8\u5e8a\u8a66\u9a57\u521d\u6b65\u6578\u64da\uff0c\u6709\u6548\u6027\u90fd\u4e0d\u8f38\u7d66\u50b3\u7d71\u76849H\uff0c\u6545\u7642\u6548\u662f\u78ba\u5b9a\u6709\u6548\u7121\u865e\u7684\u3002\u6700\u91cd\u8981\u7684\u662f\uff0c\u7531\u65bc\u6cbb\u7642\u671f\u7a0b\u8f03\u50b3\u7d71\u8655\u65b9\u77ed\u5f97\u591a\uff0c\u4ee5\u53ca\u4e00\u9031\u4e00\u6b21\u7684\u670d\u85e5\uff0c\u4e14\u90fd\u6cbb\u95dc\u61f7\u5f97\u4ee5\u843d\u5be6\u670d\u85e5\u7684\u5b8c\u6574\u6027\uff0c\u4f7f\u5f97\u6cbb\u7642\u5b8c\u6210\u7387\u986f\u8457\u7684\u4e0a\u5347\u3002\u5728\u8de8\u570b\u7684PREVENTTBTrial\u6bd4\u8f03\u8d779H\uff0c\u6cbb\u7642\u5b8c\u6210\u7387\u5206\u5225\u70ba(84% vs. 69%3)\uff0c\u8b93\u53d7\u60e0\u6c11\u773e\u6bd4\u4f8b\u660e\u986f\u63d0\u5347\u3002
\n\u4f7f\u7528\u5efa\u8b70<\/strong>
\n\u4ee5\u4e0b\u70ba\u5c0d\u65bc\u4e0d\u540c\u5e74\u9f61\u5c643HP\u7684\u4f7f\u7528\u5efa\u8b70(\u57161)\u3002\u4f9d\u64da\u7f8e\u570bCDC\u5efa\u8b70\uff0c3HP\u5efa\u8b70\u4f7f\u7528\u5e74\u9f61\u70ba12\u6b72(\u542b)\u4ee5\u4e0a\uff1b\u570b\u5916\u7814\u7a76\uff1a\u986f\u793a\u5c0d\u65bc2-11\u6b72\u7684\u5152\u7ae5\uff0c\uff0c\u9664\u6cbb\u7642\u5b8c\u6210\u7387\u986f\u8457\u63d0\u5347\u5916\uff0c\u6cbb\u7642\u4e2d\u9047\u5230\u7684\u526f\u4f5c\u7528\u4e26\u6c92\u6709\u6bd4\u50b3\u7d71\u76849H\u4f86\u5f97\u5c11\uff0c\u56e0\u6b64\u4ecd\u4ee59H\u70ba\u5efa\u8b70\u8655\u65b96\u3002\u5018\u56e0\u6545\u89ba\u5f97\u7121\u6cd5\u5982\u671f\u5b8c\u62109H\u6cbb\u7642\uff0c\u91ab\u5e2b\u53ef\u8207\u5bb6\u5c6c\u8a0e\u8ad6\uff0c\u8a55\u4f30\u4f7f\u7528\u300c\u901f\u514b\u4f0f\u300d\u4e4b\u512a\u52a3\uff0c\u59cb\u9032\u884c3HP\u8655\u65b9\u958b\u7acb\u3002\u672a\u6eff2\u6b72\u4e4b\u5152\u7ae5\uff0c\u56e0\u7f3a\u4e4f\u81e8\u5e8a\u8a66\u9a57\u6578\u64da\uff0c\u4e0d\u4e88\u5efa\u8b70\u3002<\/p>\n

\"2016-05-02_091817\"<\/p>\n

\u4e0d\u5efa\u8b70\u4f7f\u7528\u8005<\/strong>
\n\u6709\u4e09\u985e\u65cf\u7fa4\u4e0d\u9069\u7528\u300c\u901f\u514b\u4f0f\u300d(\u5716\uff12)\u8981\u7279\u5225\u63d0\u9192\u81e8\u5e8a\u91ab\u5e2b\u6ce8\u610f\uff1a\u5b55\u5a66\uff08\u6216\u6e96\u5099\u61f7\u5b55\u7684\u5a66\u5973\uff09\u3001INH\u6216Rifampin(RMP)\u6297\u85e5\u6307\u6a19\u500b\u6848\u7684\u63a5\u89f8\u8005\u3001\u53ca\u672a\u6eff2\u6b72\u4e4b\u5152\u7ae5\u3002\u6b64\u5916\uff0c\u82e5\u6f5b\u4f0f\u611f\u67d3\u8005\u540c\u6642\u670d\u7528\u5176\u4ed6\u6613\u8207RPT\u7522\u751f\u85e5\u7269\u4ea4\u4e92\u4f5c\u7528\u4e4b\u85e5\u7269\uff08\u5982\uff1aprotease inhibitors\uff0c coumadin\uff0c methadone\uff0c phenytoin\u2026\uff09\u8005(\u8a73\u898b\u9644\u4ef6\u4e00)\uff0c\u4ea6\u9808\u8a55\u4f30\u662f\u5426\u9069\u7528\u901f\u514b\u4f0f\u8655\u65b9\u3002
\n\u526f\u4f5c\u7528<\/strong>
\n\u8207\u85e5\u7269\u76f8\u95dc\u7684\u809d\u708e\u767c\u751f\u6bd4\u4f8b\uff0c3HP\u660e\u986f\u5730\u8f039H\u4f86\u5f97\u4f4e\uff080.4% vs. 2.7%\uff09\uff0c\u800c\u9020\u6210\u6c38\u4e45\u505c\u85e5\u5206\u5225\u70ba0.3-0.9%\u548c2-4.3%\u3002\u975e\u809d\u708e\u4e4b\u5c0e\u81f4\u6c38\u4e45\u505c\u85e5\u7684\u526f\u4f5c\u7528\u4e2d\uff0c\u7d04\u67093.8%\u7684\u75c5\u4eba\u6709\u5168\u8eab\u6027\u85e5\u7269\u53cd\u61c94\u3002\u5176\u4e2d\u6700\u5e38\u898b\u7684\u985e\u578b\uff1a21%\u70ba\u985e\u4f3c\u6d41\u611f\u4e4b\u75c7\u72c0\uff08flu-like syndrome\uff09\uff0c\u4f8b\u5982\uff1a\u982d\u6688\u3001\u982d\u75db\u3001\u5641\u5fc3\u6216\u5614\u5410\u3001\u808c\u8089\u75e0\u75db\u3001\u7121\u529b\u3001\u75b2\u5026\u3001\u767c\u71d2\u3001\u76dc\u6c57\u3001\u547c\u5438\u6025\u4fc3\u3001\u81c9\u7d05\u53ca\u5bd2\u986b\u7b49\u75c7\u72c0\uff1b\u9019\u7a2e\u60c5\u6cc1\u57289H\u8655\u65b9\u7684\u767c\u751f\u7387\u5247\u76f8\u7576\u4f4e\uff080.4%\u6709\u5168\u8eab\u6027\u85e5\u7269\u53cd\u61c9\uff0c\u5176\u4e2d13%\u70baflu-like syndrome\uff094\uff0c\u4e0a\u8ff0\u7684\u4e0d\u8212\u670d\u82e5\u7d93\u904e\u75c7\u72c0\u6cbb\u7642\u8207\u518d\u78ba\u8a8d\uff0c\u9020\u62103HP\u548c9H\u6c38\u4e45\u505c\u85e5\u5206\u5225\u70ba3.5%\u548c0.4%\u3002\u6b64\u985e\u5168\u8eab\u6027\u85e5\u7269\u53cd\u61c9\u526f\u4f5c\u7528\uff0c\u591a\u5728\u77ed\u6642\u9593\u5167\u53ef\u7de9\u89e3\uff0c\u4e0d\u5f71\u97ff\u670d\u85e5\uff0c\u8f03\u56b4\u91cd\u7684\u5168\u8eab\u6027\u53cd\u61c9\u7d55\u5927\u591a\u6578\u767c\u751f\u5728\u7b2c\u4e09\u5230\u7b2c\u56db\u500b\u5291\u91cf\u3002\u25a0<\/p>\n","protected":false},"excerpt":{"rendered":"

\u25a0 \u611f\u67d3\u79d1\u4e3b\u4efb \u8521\u6587\u77f3 \u91ab\u5e2b \u7d50\u6838\u75c5\u662f\u76ee\u524d\u570b\u5167\u6700\u591a\u7684\u6cd5\u5b9a\u50b3\u67d3\u75c5\uff0c10\u5e74\u524d\u570b\u5167\u7d50\u6838 … \u95b1\u8b80\u5168\u6587 →<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[106],"tags":[41,101],"class_list":["post-726","post","type-post","status-publish","format-standard","hentry","category-106","tag-health","tag-101"],"_links":{"self":[{"href":"http:\/\/epaper.pch.org.tw\/index.php?rest_route=\/wp\/v2\/posts\/726","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/epaper.pch.org.tw\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/epaper.pch.org.tw\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/epaper.pch.org.tw\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/epaper.pch.org.tw\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=726"}],"version-history":[{"count":2,"href":"http:\/\/epaper.pch.org.tw\/index.php?rest_route=\/wp\/v2\/posts\/726\/revisions"}],"predecessor-version":[{"id":754,"href":"http:\/\/epaper.pch.org.tw\/index.php?rest_route=\/wp\/v2\/posts\/726\/revisions\/754"}],"wp:attachment":[{"href":"http:\/\/epaper.pch.org.tw\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=726"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/epaper.pch.org.tw\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=726"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/epaper.pch.org.tw\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=726"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}