目的:评价醋酸泼尼松与标准抗结核药物联用对血行播散性肺结核患者抗结核分枝杆菌的疗效和安全性。方法:选取2013年7月—2016年2月间收治的血行播散性肺结核患者200例,采用随机分组法将其分为治疗组和对照组,每组100例;两组患者均给予标准抗结核药物(3 HRZE/6~9 HRE)治疗,在此基础上治疗组患者在强化期给予醋酸泼尼松治疗4周,比较两组患者治疗后的临床疗效。结果:治疗组患者治疗后的总有效率为94.00%高于对照组为85.00%(P<0.05),胸部影像学检查结果的好转率为92.00%高于对照组为81.00%(P<0.05),不良反应的发生率为7.00%低于对照组为16.00%(P<0.05)。结论:采用醋酸泼尼松与抗标准抗结核药物联用治疗血行播散性肺结核患者,能有效改善患者的临床症状与影像学表现,能降低抗结核药物不良反应的发生率,抗结核分枝杆菌的疗效优于标准抗结核药物的疗效。 OBJECTIVE: To evaluate the efficacy and safety of prednisone acetate in combination with standard anti-TB drugs in anti-TB therapy in patients with hematogenous disseminated pulmonary tuberculosis. Methods: 200 cases of hematogenous disseminated pulmonary tuberculosis were selected from July 2013 to February 2016. The patients were divided into treatment group and control group with 100 cases in each group by randomization method. Both groups were given standard anti-tuberculosis Tuberculosis drugs (3 HRZE / 6 ~ 9 HRE). On the basis of this, the patients in the treatment group were treated with prednisone acetate during the intensive phase for 4 weeks. The clinical efficacy of the two groups of patients after treatment was compared. Results: The total effective rate of the treatment group after treatment was 94.00%, which was significantly higher than that of the control group (85.00%, P <0.05). The improvement rate of the chest imaging examination was 92.00%, which was significantly higher than that of the control group (81.00%, P <0.05) , The incidence of adverse reactions was 7.00% lower than the control group was 16.00% (P <0.05). Conclusion: The combination of prednisone acetate and anti-TB antituberculosis drugs in the treatment of patients with hematogenous disseminated pulmonary tuberculosis can effectively improve the clinical symptoms and imaging findings of patients, reduce the incidence of adverse reactions of anti-tuberculosis drugs, anti-TB branch The efficacy of bacilli is superior to that of standard anti-TB drugs.