硫酸卷曲霉素超声雾化吸入联合抗结核药物治疗复治痰抗酸杆菌阳性肺结核近期疗效观察

Therapeutic effect of capreomycin ultrasonic aerosol inhalation combined with antitubercular agents on retreated sputum positive pumonary tuberculosis

目的评价硫酸卷曲霉素（CPM）超声雾化吸入联合抗结核药物治疗复治抗酸杆菌阳性（菌阳）肺结核的疗效。方法126例复治菌阳肺结核患者以随机数字表法分为治疗组和对照组，2组均以合理抗结核化疗方案，治疗组加用硫酸卷曲霉素0．75g/次，1次／d超声雾化吸入治疗。观察2组治疗前后细菌学检查及胸部影响学检查资料的变化。结果经过3个月的治疗，治疗组的痰菌阴转率为82．5％（52例），肺部病变吸收总有效率为93．6％（59例），空洞闭合或缩小的总有效率为93．6％（59例）；对照组的痰菌阴转率为61．9％（39例），肺部病变吸收总有效率为73．0％（46例），空洞闭合或缩小的总有效率为80．9％（51例）；治疗组明显优于对照组，差异有统计学意义（P〈0．01）。结论并用卷曲霉素超声雾化吸入治疗复治菌阳肺结核疗效优于对照组，远期疗效需进一步研究。

Objectives To evaluate the therapeutic effect of capreomucin （CPM）ultrasonic aerosol inhalation spray combined with antituhercular agents in the treatment of retreated sputum positive pumonary tuberculosis. Methods One hundred and twenty-six retreated patients with sputum positive of AFB were randomly divided into ：2 groups： treatment group had CPM aerosolization combined with rational chemotherapy and control group only had chemotherapy. Results After 3 months of treatment, the rates of sputum negtive conversion and radiological improvement in the treatment group were 82.5% and 93.7% respectively, much higher than those in the control group （73.0% and 80.9% respectively） （ P 〈 0.01 ）. Conclusion Our study showes that antitubercular agents with CPM ultrasonic aerosolization have better therapeutic effect than chemotherapy alone.