静脉滴注硫酸卷曲霉素治疗复治肺结核临床疗效观察

Observation of the efficacy of capreomycin infusion in treatment of recurrent tuberculosis

目的 :探讨硫酸卷曲霉素静脉滴注制剂对复治肺结核患者的疗效。方法 :根据有关标准选取复治肺结核病例 ,按 2∶1随机分为试验组和对照组 ,采用含卷曲霉素、异烟肼、利福平、吡嗪酰胺及乙胺丁醇等抗结核药物联合方案 (2CHRZE/6H3 R3 E3 )进行治疗观察。结果 :卷曲霉素试验组与对照组 2个月末痰阴转率分别为 70 .5 %和 6 9.6 % ,无显著性差异 ;不良反应发生率分别为 2 1.8%和 47.1% ,有显著性差异 (P <0 .0 1)。对照组以注射部位疼痛、硬结为主 ,试验组以低血钾为多 ,处理后均可恢复正常。结论 :硫酸卷曲霉素静脉滴注制剂治疗复治肺结核效果肯定 ,与肌内注射应用同样有效 ;静脉滴注卷曲霉素比肌肉注射较少发生不良反应 ,但应注意及时纠正低血钾 ;静脉滴注卷曲霉素制剂避免了注射部位的硬结、疼痛 ,减少了患者痛苦 ,是复治结核病患者较好的备选药物。

Objective::As stated in the title.Methods:The study was conducted in 218 patients with recurrent tuberculosis.They were randomly divided into active and control group in a rough ratio of 2∶1 and treated with a combined regimen (2CHRZE/6H 3R 3E 3) of capreomycin,isoniazid,rifampin,pyrazinamide and ethanbutol with a different administration route of capreomycin.It was given by infusion in active group while by intramuscular route in control group.Results:After 2 months of treatment,non significant difference in spit negative rate(70.5% in active group and 69.6% in control group)and a significant difference in incidence rate of ADRs(21.8% in active group and 47.1% in control group) were achieved( P <0.01).Low blood potassium level was the main side effect in active group and pain and induration in injection site were the main side effects in control group.Conclusion:Similar spit negative rate was achieved in both administration route (infusion and intramuscular route) of capreomycin and with fewer side effect and low blood potassium level in infusion route.