医学研究与教育 ›› 2021, Vol. 38 ›› Issue (6): 22-26.DOI: 10.3969/j.issn.1674-490X.2021.06.004

• 临床医学 • 上一篇    下一篇

常规化疗联合莫西沙星或左氧氟沙星治疗耐多药肺结核的临床疗效对比

马清艳   

  1. 河北省胸科医院结核四科, 河北 石家庄 050041
  • 收稿日期:2021-05-07 出版日期:2021-12-25 发布日期:2021-12-25
  • 作者简介:马清艳(1983—),女,河北石家庄人,主治医师,硕士,主要从事耐药肺结核诊治。 E-mail: 513507607@qq.com

  • Received:2021-05-07 Online:2021-12-25 Published:2021-12-25

摘要: 目的 探究对比常规化疗联合莫西沙星或左氧氟沙星治疗耐多药肺结核的临床疗效。方法 选择2019年11月至2021年2月接受治疗的98例耐多药肺结核患者,根据随机数字表法将患者分为2组,其中观察组49例给予常规化疗联合莫西沙星治疗,对照组49例给予常规化疗联合左氧氟沙星治疗,治疗后对比2组临床疗效、免疫功能、病灶吸收率、痰菌转阴率、空洞闭合率以及不良反应等情况。结果 治疗后观察组总有效率为71.43%,高于对照组(P<0.05)。治疗18个月观察组痰菌转阴率、病灶吸收率以及空洞闭合率分别为42.86%、40.82%、46.94%,均高于对照组(P<0.05); 治疗18个月观察组CD4+为(41.83±9.02)%, IgA为(4.08±0.62)g/L,IgG为(19.84±3.40)g/L,均高于对照组(P<0.05),CD8+为(29.83±5.62)%,低于对照组(P<0.05)。2组治疗时不良反应发生率比较,差异无统计学意义(P>0.05)。结论 耐多药肺结核患者接受常规化疗联合莫西沙星治疗能够提高患者免疫功能,控制不良反应的发生,疗效确切。

关键词: 莫西沙星, 左氧氟沙星, 常规化疗, 耐多药肺结核

Abstract: Objective To explore and compare the clinical efficacy of conventional chemotherapy combined with moxifloxacin or levofloxacin in the treatment of patients with multi-drug resistant pulmonary tuberculosis. Methods 98 patients with MDR-TB were selected from November 2019 to February 2021. According to the random digital table method, the patients in observation group were divided into two groups, 49 patients in observation group were treated with conventional chemotherapy and moxifloxacin, 49 cases in control group were treated with conventional chemotherapy and levofloxacin, and then compared after treatment. The clinical efficacy, immune function, focus absorption rate, sputum bacteria negative rate, cavity closure rate and adverse reactions were observed in the two groups. Results After treatment, the total effective rate of the observation group was 71.43%, which was significantly higher than that of the control group(P<0.05). After 18 months of treatment, the sputum negative conversion rate, lesion absorption rate and cavity closure rate of the observation group were 42.86%, 40.82% and 46.94%, respectively, which were significantly higher than those of the control group(P<0.05). After 18 months of treatment, the CD4+ in the observation group was(41.83±9.02)%, IgA was(4.08±0.62)g/L, IgG was(19.84±3.40)g/L,which were significantly higher than the control group. CD8+ was(29.83±5.62)%, which was significantly lower than that of the control group(P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups during the treatment(P>0.05). Conclusion The treatment of multi-drug resistant tuberculosis patients with conventional chemotherapy combined with moxifloxacin can significantly improve the immune function of patients, control the occurrence of adverse reactions, and the effects are accurate, which are worth popularizing and adopting in clinical practices.

Key words: moxifloxacin, levofloxacin, routine chemotherapy, multi drug resistant tuberculosis

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