司帕沙星治疗耐多药肺结核疗效临床研究

Clinical Study on the Curative Effect of Sparfloxacin for Multi-drug-resistant Tuberculosis Treatment

[目的]评价含司帕沙星(SPLX)化疗方案对耐多药结核病(MDR-TB)的临床应用价值。[方法]将64例MDR-TB患者随机分为两组各32例,治疗组用司帕沙星0.2 g每晚口服;对照组氧氟沙星(OFLX)0.2 g,3次/d。化疗方案:治疗组3 SPL2ZPTh(E)/9 SPL2Th;对照组3 OL2ZPTh(E)/9 OL2Th。比较治疗3个月、12个月的痰菌阴转率、X线胸片变化、药物不良反应及39例随访2年的复发率。[结果]治疗组3个月痰菌阴转率(75.0%)高于对照组(46.8%,P<0.05);两组满疗程阴转率(90.3%、70.0%)、满疗程X线病灶吸收率(90.3%、60.0%)和空洞闭合率(85.7%、51.8%)差异均显著(P<0.05);39例随访2年复发率分别0%和21.1%(P<0.05)。两组皆无严重不良反应。[结论]SPLX对MDR-TB近期临床疗效显著,具有剂量小、疗程短、2年复发率低的优势。

[Objective] To study the clinical curative effect of Sparfloxacin （SPLX） for the treatment of muhi-drug-resistant pulmonary tuberculosis （MDR-TB）. [Methods] 64 MDR-TB eases were divided into 2 groups. 32 cases were cured with SPLX 0.2/qn （Case-group） and 32 cases were cured with ofloxacin 0.2/tid and other anti-TB drugs （TH. Z. PAS. etc, Control-group）. The therapy plans were 3 SpL2ZPTh （E）/9 SpL2 Th for Case-group and 3OL2ZPTh （E）/9 OL2Th for Control-group respectively. The rates of sputum negative conversion, X-ray changing and drug side effect were compared in 3rd month and 12th month, and recurrence rate was observed for 2 years （n=39）. [Results] The sputum negative conversion rates in Case-group was higher than that in Control group （75.0% and 46.9%） in 3rd mouth ;Sputum negative conversion rate, focal absorption rate and closure rate of cavities in 12th mouth （90.3 %, 90. 3 and 85.7%） were higher than those （70.0%, 60.0% and 51.8%, P〈0.05）. The recurrence rate in Case-group （0%） was lower than that in Control-group （21.1%, P〈0.05） and no severe adverse reactions in 2 groups. [Conclusion] There are significant clinical curative effects to cure MDR-TB by SPLX with low dosage, short course of treatment and low recurrence rate.