腎結核の臨床 とくに腎結核の化学療法について (シンポジウム: 尿路性器結核の昨日・今日・明日 第22回日本泌尿器科中部連合地方会 )

Abstract

Adequate follow-up was available on 388 patients with renal tuberculosis who had received chemotherapy at the Urological Clinic of Nagoya University during the 15 years period from 1957 to 1971. In 388 patients who received single course of treatment, successful arrest of their disease was 88.1 per cent, while 43 (11.1 per cent) of the 388 patients relapsed bacteriologically after treatment. The relapse rate of 105 out of the 388 patients with renal tuberculosis who had a period of 6 years follow-up after the start of chemotherapy for renal tuberculosis was 16.2 per cent. After a triple drug regimen employing cycloserine (CS) 250 mg to 500 mg daily, isoniazid (INH) 300 mg to 600 mg daily, and sodium or calcium para-aminosalicylic acid (PAS) 5g to 10g daily, or streptomycin (SM) 1g BIW or TIW, INH 300 mg to 600 mg and PAS 5 g to 10g daily, success rate in 105 patients with renal tuberculosis was 91.8 per cent and 85.3 per cent respectively. On the other hand, in patients who received a two drug regimen employing INH-PAS, SM-INH and SM-PAS, success rate was 80 per cent, 79 per cent and 40 per cent respectively. The highest rate of relapse was noted in patients with renal tuberculosis in a solitary kidney. All relapse was eventually arrested by a second course of chemotherapy. Furthermore, to study on limitation of chemotherapy for renal tuberculosis, aortography and microangiography were performed and all cases with renal tuberculosis were divided in four groups following various findings of renal arteries.