耐多药性肺结核的临床疗效观察

Curative effect observation on multiple drug resistant pulmonary tuberculosis

目的探讨克拉霉素、对氨基水杨酸异烟肼(力克肺疾)联合治疗耐多药性肺结核(MDR-TB)的临床疗效。方法选取2011年3月～2012年3月本院80例耐多药性肺结核患者,将其随机分为治疗组和对照组,每组各40例。对照组给予异烟肼、左氧氟沙星、丁胺卡那霉素和丙硫异烟胺常规疗法,治疗组在对照组基础上加用克拉霉素和对氨基水杨酸异烟肼(力克肺疾)治疗。观察并比较两组患者的痰菌转阴情况、病灶变化情况和不良反应。结果治疗组治疗后3个月和6个月的痰菌转阴率均优于对照组,差异有高度统计学意义(P<0.01)。治疗后,治疗组病灶吸收情况明显优于对照组,差异均有统计学意义(P<0.05,P<0.01)。两组不良反应多以胃肠道症状和肝功能损害多见。结论应用克拉霉素、对氨基水杨酸异烟肼(力克肺疾)联合治疗MDR-TB疗效确切,副作用小,值得临床推广应用。

Objective To explore the clinical effect on Clarithromycin combined with Dipasic in the treatment of multiple drug resistant pulmonary tuberculosis （MDR-TB）. Methods Eighty patients with MDR-TB in our hospital from March 2011 to March 2012 were selected, and randomly divided into treatment group and control group, each group had 40 cases. Control group was given conventional therapy including Isoniazide, Levofloxacin, Amikacin and Protionamide. Treatment group was given Clarithromyein combined with Dipasic based on the treatment of control group. Negative sputum conver- sion situation, lesions change and adverse reaction of two groups were observed and compared. Results Negative sputum conversion rate of treatment group were better than that of control group after 3 months and 6 months treatment, there were significant difference （P 〈 0.01）. Lesions change of treatment group was better than that of control group （P 〈 0.05; P 〈 0.01）. Gastrointestinal symptoms and liver damage were main adverse reactions of two groups. Conclusion Using of Clar- ithromycin combined with Dipasic in the treatment of MDR-TB has a remarkable curative effect with less adverse reaction, so it is worthy to use in clinic.