化疗联合免疫调节优化治疗耐多药结核病的疗效观察

Efficacy of Chemotherapy plus Immunomodulatory Therapy for Optimized Treatment of Multidrug-resistant Tuberculosis

目的:评价化疗联合免疫调节优化治疗耐多药结核病的临床效果。方法:将88例患者随机分为治疗组(n=46)和对照组(n=42),化疗方案均为对氨基水杨酸异烟肼+利福喷丁+左氧氟沙星+阿米卡星,治疗组前6个月加用母牛分枝杆菌菌苗治疗。结果:治疗18个月后,治疗组患者和对照组患者咳嗽、低热等症状改善率分别为76%、63%,痰菌阴转率分别为65.2%、52.3%,病灶吸收率分别为58.7%、45.2%,治疗组患者各项指标改善明显优于对照组患者(P<0.05)。结论:化疗联合免疫调节治疗,在改善症状、痰菌转阴、病灶吸收等方面均优于对照组,是治疗耐多药结核病的有效措施。

OBJECTIVE：To evaluate the clinical efficacy of chemotherapy plus immunomodulatory therapy for optimized treatment of multidrug-resistant tuberculosis. METHODS：88 patients were randomly divided into treatment group（n=46）and control group（n=42）,with chemotherapy regimens consisting of pasiniazide,rifapentine,levofloxacin and amikacin. The treatment group was given add-on mycobacterium vaccae vaccine therapy for the first 6 months. RESULTS：After 18 months of treatment,the treatment group and the control group showed improvement rate of 76% vs. 63% in symptoms of cough and fever and other symptoms,sputum negative conversion rate of 65.2% vs. 52.3%,and lesion absorption rate of 58.7% vs. 45.2 %,indicating that all indexes in the treatment group were significantly better than in the control group（P0.05）. CONCLUSIONS：Chemotherapy combined with immunomodulatory therapy was better than chemotherapy alone in improving symptoms,sputum negative conversion and lesion absorption,which thus is an effective therapy for multidrug-resistant tuberculosis.