左氧氟沙星联合多种药物治疗老年初治肺结核病的疗效及安全性分析

Study on the Clinical Efficacy and Safety of a Combination Regimen with Levofloxacin in the Initial Treatment of Pulmonary Tuberculosis in Elder Individuals

目的探讨左氧氟沙星联合多种药物治疗老年初治肺结核病的疗效及安全性。方法选取老年初治涂阳肺结核患者126例,按就诊顺序分为治疗组和对照组,两组患者均采用异烟肼、利福平、乙胺丁醇、利福喷汀治疗,治疗组在此基础上加用左氧氟沙星,对照组加用吡嗪酰胺,疗程共9个月。结果治疗9个月后两组痰菌阴转率分别为94.7%和90.8%,差别无显著性意义(P>0.05);2年痰菌阳转率分别为10.6%和6.5%,差别无显著性意义(P>0.05);X线好转率分别为85.6%和87.7%,差别无显著性意义(P>0.05);空洞闭合率分别为33.3%和30.2%,差别无显著性意义(P>0.05);药物不良反应率分别为24.3%和55.8%,差别有显著性意义(P<0.01)。结论含左氧氟沙星治疗方案对老年初治涂阳肺结核的疗效满意,不良反应小。

Objective To study the clinical efficacy and safety of a combination therapy with levofloxacin(LVFX) and other antituberculosis drugs in the treatment of elderly patients with newly detected pulmonary tuberculosis.Methods 126 elderly patients with newly detected active pulmonary tuberculosis were randomly assigned to a study group,treated with LVFX,rimifon,rifampicin,ethambutol,eifapentine;or a control group,treated with pyrazinamide,rimifon,rifampicin, ethambutol,rifapentine.The course of treatment was 9 months.Results There were no significant difference in the sputum negative conversion rate between study group(94.7%) and control group(90.8%) (P>0.05).A 2-year follow-up assessment for sputum negative conversion rate was 10.6% in study group and 6.5% in control group(P>0.05).No significant difference was found in the radiographic improvement rate (85.6% vs 87.7%) and in the closure rate of the lung cavities(33.3% vs 30.2%) between two groups(P>0.05).Adverse reactions (or side-effects) occurred at 24.3% in study group,significantly lower than that in control group(55.8%) (P<0.01).Conclusion The regimen including LEVX,rimifon,rifampicin,ethambutol,rifapentine was effective and safe for elder patients with untreated active pulmonary tuberculosis.