左氧氟沙星治疗耐多药肺结核病近期临床疗效观察

Short-term clinical effect of levofloxacin in the treatment of patients with multidrug-resistant pulmonary tuberculosis

目的探讨左氧氟沙星治疗耐多药肺结核病(MDR-PTB)患者的近期临床疗效。方法将80例确诊为MDR-PTB患者随机分组为对照组和治疗组。其中,对照组40例采用3SEL2DZ/15EL2D方案治疗,治疗组40例采用3Cm VL2DZ/15VL2D方案治疗。结果疗程结束时,治疗组的临床症疗效总有效率为85.0%,对照组的总有效率为62.5%,组间比较差异有统计学意义(P<0.05),治疗组的临床疗效优于对照组;在治疗3个月和疗程结束时,治疗组的痰菌阴转率分别为67.5%和87.5%,对照组的痰菌阴转率分别为45.0%和67.5%,组间比较差异有统计学意义(P<0.05),治疗组的痰菌阴转率大于对照组;在疗程结束时,治疗组的病灶吸收和空洞闭合好转率分别为92.5%和88.9%,对照组的病灶吸收和空洞闭合好转率分别为72.5%和68.6%,组间比较差异有统计学意义(P<0.05),治疗组的病灶吸收和空洞闭合改善更加明显。在治疗期间,治疗组的不良反应发生率低于对照组,但是组间比较差异无统计学意义(P>0.05)。结论左氧氟沙星治疗MDR-PTB患者的临床疗效好,值得临床推广应用。

Objective To investigate the short-term clinical effect of levofloxacin in the treatment of patients with multidrug resistant pulmonary tuberculosis （MDR-PTB）. Methods Eighty patients with MDR-PTB were ran-domly divided into the control group and the treatment group, each with 40 cases. Therapy of 3SEL2DZ/15EL2D and 3CmVL2DZ/15VL2D were adopted in the control group and the treatment group, respectively. Results At the end of treatment process, the total effective rate of the treatment group was 85.0%, significantly higher than 62.5%in the con-trol group （P〈0.05）. The clinical effect of the treatment group was better than that of the control group. After 3 months and 18 months of treatment, the negative conversion rate of acid-fast bacilli sputum smear was 67.5%and 87.5%in treatment group, 45.0%and 67.5%in control group, respectively, with significant difference between the two groups （P〈0.05）. At the end of treatment process, the improvement rate of clinical symptoms of lesions absorption and cavity closure was 92.5%and 88.9%in treatment group, 72.5%and 68.6%in the control group, respectively, with statistical-ly significant difference between the two groups （P〈0.05）. In the treatment process, the incidence rate of adverse reac-tions in treatment group was lower than that of control group, but there was no statistically significant difference （P〉0.05）. Conclusion There is significant clinical effect of levofloxacin in treatment of patients with MDR-PTB. The therapy is worthy of clinical popularization and application.