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本文从1982～1992年1283例初治肺结核病例中选出597例完成化疗方案者进行吸烟与不吸烟两组疗效对比观察发现,不吸烟组与吸烟组治愈率分别为 81.88％和65.51％(P<0.01);初治菌阳病例不吸烟组与吸烟级治愈率分别为94.67％和65.63％(P<0.01);随着烟龄的增长,治愈率由<10年的82.35％降到>30年的46.34％。而无变化和恶化病例均出现在吸烟组的烟龄很长的病例中。探讨吸烟使疗效下降原因,不外乎与吸烟引起肺功能损伤,降低氧代谢能力;肺内免疫球蛋白变化,使体液免疫低下;使肺巨噬细胞活力减低,杀菌力差,死亡数增多;使许多药物代谢受影响,尤其明显地降低利福平的血浓度和药敏度,削弱了杀菌力,增加了结核菌耐药性。
In this paper, from 1982 to 1992, 1283 cases of newly diagnosed tuberculosis cases were selected 597 cases completed chemotherapy were smoking and no smoking comparison of two groups found that smoking, non-smoking group and smoking group cure rates were 81.88% and 65.51% (P <0.01). The cure rates of no-smoking group and smoking-grade group were 94.67% and 65.63% respectively (P <0.01). The cure rate decreased from 82.35% in 10 years to more than 30 with the increase of smoking age 46.34% of the year. No change or worsened cases were found in the smoker’s long-smoked cases. Explore the reasons for the decline in smoking effect, nothing more than lung injury caused by smoking and reduce oxygen metabolism; intrapulmonary immunoglobulin changes, so humoral immunity is low; so that the activity of pulmonary macrophages decreased, the bactericidal power is poor, the increase in the number of deaths; So that many drug metabolism affected, in particular, significantly reduce the rifampin blood concentration and susceptibility, weaken the bactericidal power, increased resistance to tuberculosis.