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MethodsContactshadatuberculinskintest(TST).LTBIamongadultswasdefinedas≧5mmofind... Methods
Contacts had a tuberculin skin test (TST). LTBI among adults was defined as ≧5 mm of induration to five units of purified protein derivative (PPD), without radiographic or clinical evidence of active tuberculosis.(5) All exposed children were treated, regardless of TST results, because young children are at risk for developing rapid, disseminated tuberculosis.(5) Treatment is suspended if a TST 10 weeks later is alsonegative.(5)
Contacts with LTBI had a baseline history and physical examination. Pyrazinamide was prescribed according to patient’s weight at 15 mg/kg (maximum dose 2g) daily. Ri-fampin was prescribed at 10 mg/kg (maximum daily dose 600 mg) for children and 600 mg daily for all adults. Children received directly observed preventive therapy (DOPT); adultsself-administered treatment.
Adults received 2 weeks of medication per visit and were monitored with bi-weekly liver enzymes and clinical exam.(9) Because of limited data on RIF/PZA in children, there is no standard for monitoring.(13) The children underwent clinical assessment bi-weekly, but did not have liver enzymes mea-sured as frequently. Contacts (or parents) were counseled about possible hepatotoxicity.
Treatment completion was defined as self-report of 8 weeks of treatment (not number of doses) for adults, and 8 weeks of DOPT in children. Drug-induced hepatitis was defined according to guidelines,(9) as either serum aminotransferase elevation more than five times the upper limit of normal(>200 U/L for both aspartate [AST] and alanine transaminases [ALT] in women and >200 U/L for AST and >225 U/L for ALT in men) or symptoms of hepatotoxicity (nausea, abdominal pain, jaundice, fatigue) accompanied by liver enzymes more than three times the upper limit of normal. RIF/PZA was suspended if drug-induced hepatitis was diagnosed.
Data were collected through chart abstraction and interviews with health department employees. Abstracted data included demographics, clinical information, comorbidities,other medication use, laboratory test results, types, dosages and duration of LTBI treatment, side effects, and completion rates. Alcohol consumption at baseline was categorized as yes or no because quantity was not always documented. Semi-structured interviews with four health department employees explored the benefits and limitations of short-course therapy.Cost analysis for an uncomplicated 2-month course of RIF/PZA versus 4 months of rifampin included medication costs and laboratory testing.
Adults who developed hepatotoxicity were compared to those who did not with Fisher exact tests for categorical variables and with Wilcoxon rank-sum tests for continuous variables. Data were analyzed using STATA 7.0 (Stata Corpo-ration, College Station TX, 2001).
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Methods
方法

Contacts had a tuberculin skin test (TST). LTBI among adults was defined as ≧5 mm of induration to five units of purified protein derivative (PPD), without radiographic or clinical evidence of active tuberculosis.(5) All exposed children were treated, regardless of TST results, because young children are at risk for developing rapid, disseminated tuberculosis.(5) Treatment is suspended if a TST 10 weeks later is also negative.(5)
对接触者进行了结核菌素皮肤测试(TST)。成人中的隐匿性结核感染(LTBI)被定义为对五个单位的纯化蛋白衍化物(PPD)≧5 mm的硬结,通过X光照片或临床检查没有活性肺结核的征兆。(5)因为年幼的儿童有快速然生并传播结核病的危险,所有接触过(感染源)的儿童都经过治疗,不管其结核菌素皮肤测试(TST)结果如何。如果10周后的TST仍呈阴性,则暂停治疗。(5)

Contacts with LTBI had a baseline history and physical examination. Pyrazinamide was prescribed according to patient’s weight at 15 mg/kg (maximum dose 2g) daily. Rifampin was prescribed at 10 mg/kg (maximum daily dose 600 mg) for children and 600 mg daily for all adults. Children received directly observed preventive therapy (DOPT); adults self-administered treatment.
对携带隐匿性结核感染(LTBI)的接触者进行了原发史检查和体检。根据患者体重,每天按15毫克/公斤(最大剂量为2克)开给吡嗪酰胺治疗。儿童每天按10毫克/公斤(最大剂量为每日600毫克)开给利福平,而所有成人每天都按600毫克开给利福平治疗。儿童接受直接观察的预防性疗法 (DOPT),成人则进行自我治疗。

Adults received 2 weeks of medication per visit and were monitored with bi-weekly liver enzymes and clinical exam.(9) Because of limited data on RIF/PZA in children, there is no standard for monitoring.(13) The children underwent clinical assessment bi-weekly, but did not have liver enzymes measured as frequently. Contacts (or parents) were counseled about possible hepatotoxicity.
成人每次就诊获两周的药,且获得两周一次的肝酶和临床检查,继续监督。(9)因为关于儿童体内抗结核药物/吡嗪酰胺(RIF/PZA)的数据有限,所有还没有监控标准。(13)对儿童进行两周一次的临床评价,但是没有那么频繁测量肝酶。就可能出现肝中毒的现象,对接触者(或父母)进行咨询。

Treatment completion was defined as self-report of 8 weeks of treatment (not number of doses) for adults, and 8 weeks of DOPT in children. Drug-induced hepatitis was defined according to guidelines,(9) as either serum aminotransferase elevation more than five times the upper limit of normal(>200 U/L for both aspartate [AST] and alanine transaminases [ALT] in women and >200 U/L for AST and >225 U/L for ALT in men) or symptoms of hepatotoxicity (nausea, abdominal pain, jaundice, fatigue) accompanied by liver enzymes more than three times the upper limit of normal. RIF/PZA was suspended if drug-induced hepatitis was diagnosed.
治疗完成定义为成人自报进行了8周的治疗(而不是药剂数),或儿童进行了8周的二羟苯丙氨酸治疗。根据准则,药物引发的肝炎定义为(9)要么血清转氨酶升高至正常值上限的五倍[女性的谷草转氨酶(AST)和谷丙转氨酶(ALT)二者都>200 U/L,男性的谷草转氨酶>200 U/L,内丙转氨酶>225 U/L],或者是出现肝中毒症状(恶心、腹部疼痛、黄疸、疲劳),伴有肝酶超出正常上限三倍以上。如果已诊断患有药物引发性肝炎,体内抗结核药物/吡嗪酰胺(RIF/PZA)暂停实施。

Data were collected through chart abstraction and interviews with health department employees. Abstracted data included demographics, clinical information, comorbidities, other medication use, laboratory test results, types, dosages and duration of LTBI treatment, side effects, and completion rates. Alcohol consumption at baseline was categorized as yes or no because quantity was not always documented. Semi-structured interviews with four health department employees explored the benefits and limitations of short-course therapy. Cost analysis for an uncomplicated 2-month course of RIF/PZA versus 4 months of rifampin included medication costs and laboratory testing.
数据是通过图表提取和与卫生部门员工访谈收集到的。提取出来的数据包括人口统计、临床信息、并存疾病情况、其它药物使用情况、实验室检查结果、隐匿性结核感染(LTBI)者治疗的类型、剂量和时间、副作用即完成率。基线调查时,对饮酒只按有或没有分类,因为数量并不总是有所记录的。与卫生部门四名员工进行的半正式的访谈探索了短期疗程治疗的好处和局限性。并对两个月的体内抗结核药物/吡嗪酰胺(RIF/PZA)简单疗程和为期四个月的利福平疗程,包括药物治疗成本和实验室测试,进行了成本比较分析。

Adults who developed hepatotoxicity were compared to those who did not with Fisher exact tests for categorical variables and with Wilcoxon rank-sum tests for continuous variables. Data were analyzed using STATA 7.0 (Stata Corporation, College Station TX, 2001).
对发展为肝中毒的成人与那些没有患肝中毒的成人,使用了费舍尔分类变数精确测试和威尔科克斯等级和连续变数检定办法进行对照,并使用STATA 7.0(美国德克萨斯州学院站Stata公司2001年研制的、国外通行的计量经济学软件--译注)进行分析。
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Methods
方法

Contacts had a tuberculin skin test (TST). LTBI among adults was defined as ≧5 mm of induration to five units of purified protein derivative (PPD), without radiographic or clinical evidence of active tuberculosis.(5) All exposed children were treated, regardless of TST results, because young children are at risk for developing rapid, disseminated tuberculosis.(5) Treatment is suspended if a TST 10 weeks later is also negative.(5)

接触者进行过结核菌素皮肤测试(TST)。在没有X光照片或者活性肺结核临床证明的情况下,成人中的隐匿性结核感染(LTBI)被解释为对五个单位的精制蛋白衍化物(PPD)≧5 mm的硬结(5)。因为年幼的儿童处于迅速发展的播散性结核,不考虑结核菌素皮肤测试(TST)结果,所有接触过的儿童都经过治疗(5)。如果10周以后的结核菌素皮肤测试(TST)还是阴性,治疗暂停。

Contacts with LTBI had a baseline history and physical examination. Pyrazinamide was prescribed according to patient’s weight at 15 mg/kg (maximum dose 2g) daily. Rifampin was prescribed at 10 mg/kg (maximum daily dose 600 mg) for children and 600 mg daily for all adults. Children received directly observed preventive therapy (DOPT); adults self-administered treatment.

携带隐匿性结核感染(LTBI)的接触者有过原发史和身体检查。根据患者体重,每天按15毫克/公斤(最大量为2克的片剂)施以吡嗪酰胺治疗。儿童每天按10毫克/公斤(最大量为每日600毫克的片剂),所有成人每天都按600毫克施以利福平治疗。儿童接受直接观察预防治疗 (DOPT),成人则进行自我管理治疗。

Adults received 2 weeks of medication per visit and were monitored with bi-weekly liver enzymes and clinical exam.(9) Because of limited data on RIF/PZA in children, there is no standard for monitoring.(13) The children underwent clinical assessment bi-weekly, but did not have liver enzymes measured as frequently. Contacts (or parents) were counseled about possible hepatotoxicity.

成人接受2周一次的就诊治疗并以双周肝酶和治疗检查接受监控。(9)因为儿童体内抗结核药物/吡嗪酰胺(RIF/PZA)的有限数据,还没有监控标准。(13)儿童经历了两周的临床评价,但是没有作为频繁界定的肝酶。接触者(或父母)受到可能的肝中毒的忠告。

Treatment completion was defined as self-report of 8 weeks of treatment (not number of doses) for adults, and 8 weeks of DOPT in children. Drug-induced hepatitis was defined according to guidelines,(9) as either serum aminotransferase elevation more than five times the upper limit of normal(>200 U/L for both aspartate [AST] and alanine transaminases [ALT] in women and >200 U/L for AST and >225 U/L for ALT in men) or symptoms of hepatotoxicity (nausea, abdominal pain, jaundice, fatigue) accompanied by liver enzymes more than three times the upper limit of normal. RIF/PZA was suspended if drug-induced hepatitis was diagnosed.

治疗完成定义为成人8周治疗(非药剂数)的自述和儿童体内8周的二羟苯丙氨酸。药物性肝炎根据准则,定义为血清转氨酶升高五倍于正常上限(谷草转氨酶[AST]和妇女体内谷丙转氨酶[ALT]二者都>200 U/L,谷草转氨酶>200 U/L,男子体内丙转氨酶>225 U/L)或者妇女体内的肝中毒症状(恶心、腹部疼痛、黄疸、疲劳)伴有肝酶三倍于正常上限。如果药物性肝炎已经诊断,体内抗结核药物/吡嗪酰胺(RIF/PZA)暂停。

Data were collected through chart abstraction and interviews with health department employees. Abstracted data included demographics, clinical information, comorbidities, other medication use, laboratory test results, types, dosages and duration of LTBI treatment, side effects, and completion rates. Alcohol consumption at baseline was categorized as yes or no because quantity was not always documented. Semi-structured interviews with four health department employees explored the benefits and limitations of short-course therapy. Cost analysis for an uncomplicated 2-month course of RIF/PZA versus 4 months of rifampin included medication costs and laboratory testing.

数据是通过图标提取和与卫生部门职工访谈收集到的。提取出来的数据包括人口统计、临床信息、并存疾病情况、其药物使用情况或然实验室检查结果。因为数量始终没有记录在案,基线水平的酒精类消费情况按是或否分类。与卫生部门职工半结构式的访谈探索了短期疗程治疗的长处和局限性。对体内抗结核药物/吡嗪酰胺(RIF/PZA)与利福平对比的两个月简单疗程的成本分析包括药物治疗成本和实验室测试。

Adults who developed hepatotoxicity were compared to those who did not with Fisher exact tests for categorical variables and with Wilcoxon rank-sum tests for continuous variables. Data were analyzed using STATA 7.0 (Stata Corporation, College Station TX, 2001).

发展为肝中毒的成人与那些没有用费舍尔分类变数精确测试和威尔科克斯等级和连续变数检定的人对照。数据使用数据管理统计绘图软件STATA 7.0(坦克萨斯州学院站Stata公司,2001).
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