含左旋氧氟沙星方案治疗首次复治涂阳肺结核的疗效观察

OBSERVATION OF THERAPEUTIC EFFECTS OF LEVOFLOXACIN-CONTAINING REGIMEN ON PATIENTS WITH FIRST RETREATMENT OF SMEAR-POSITIVE PULMONARY TUBERCULOSIS

目的评价含左旋氧氟沙星方案对治疗首次复治涂阳肺结核的临床疗效。方法将86例患者随机分为研究组和对照组,每组43例,研究组采用采用3HLZEV/6HLE含左旋氧氟沙星治疗方案,对照组采用3 HLZE/6HLE不含左旋氧氟沙星治疗方案。比较2组的痰结核菌阴转情况、病灶变化情况和不良反应情况。结果研究组痰结核菌阴转率为81.40%,显著高于对照组的37.21%(P<0.05);空洞闭合率和病变吸收率分别为58.14%和90.70%,均显著高于对照组的23.26%(P<0.05)、62.79%(P<0.05);2组均出现肝损害和胃肠道反应等不良反应,差异无统计学意义(P>0.05)。结论含左旋氧氟沙星方案治疗首次复治涂阳肺结核疗效显著,不良反应少,无交叉耐药,值得临床推广。

Objective To evaluate therapeutic effects of levofloxacin-comaining regimen on patients with first retreatment of smear-positive pulmonary tuberculosis. Methods Eighty-six patients were randomly divided into study group （ n = 43 ） and control group （ n = 43 ）. The study group was treated with the regimen of 3HLZEV/6HLE containing levofloxacin, and the control group was treated with the regimen of 3HLZE/6HLE without levofloxacin. TB sputum negative conversion, lesion changes and adverse reactions were compared between the two groups. Results At the end of treatment, the rate of TB sputum negative conversion in the study group （81.40%） was significantly higher than that in the control group（37.21%） （P 〈0.05）. Pore closure rate and lesion absorption rate of the study group was significantly higher than that of control group. Both groups occurred liver damage and gastrointestinal reactions, whereas there was no significant difference. Conclusion Levofloxacin-containing regimen is effective for the treatment of patients with first retreatment of smear-positive pulmonary tuberculosis. Moreover, side effects are less and no cross-resistance.