利福布丁联合莫西沙星方案治疗耐多药结核病的疗效分析

Efficacy of rifabutin in combination with moxifloxacin in the treatment of MDR-TB

目的评价利福布丁联合莫西沙星方案治疗耐多药结核病(MDR-TB)的临床疗效。方法选取经药物敏感性试验确诊的90例肺MDR-TB患者,随机分为联合用药组(A组)和常规治疗组(B组),每组各45例。B组常规使用含莫西沙星方案(6ZKm Mfx Cs Pto/18Z Mfx Cs Pto),A组在此基础上加用利福布丁口服。观察并比较2组患者在治疗后3、6、12、18个月痰液培养结核杆菌阴转率、肺部病灶吸收情况及不良反应的发生率。结果治疗12、18个月后,A组的痰结核杆菌培养阴转率均高于B组(P均<0.05)。A组患者肺部病灶吸收情况优于B组(P<0.05)。治疗期间2组患者的不良反应均经对症治疗后好转,2组不良反应发生率比较差异无统计学意义(P>0.05)。结论采用利福布丁与莫西沙星联合用药方案治疗MDR-TB可有效促进痰结核杆菌培养阴转、肺部病灶吸收,且安全性良好。

Objective To evaluate the clinical efficacy of rifabntin combined with moxifloxacin in the treatment of multidrug-resistant tuberculosis （MDR-TB）. Methods A total of 90 patients diagnosed with MDR-TB, confirmed by a drug susceptibility test, were randomly divided into a combination therapy group （ Group A） and a conventional therapy group （ Group B）, with 45 patients in each group. The patients in Group B received the standard treatment regimen of moxifloxacin （6ZKmMfxCsPto/18Z MfxCsPto）, while the patients in Group A were administered oral rifabutin in addition to standard treatment regimen of moxifloxacin. The patients in these two groups were compared after 3, 6, 12 and 18 months of treatment with respect to the conversion rate of mycobacterium tuberculosis-negative sputum culture, extent of pulmonary lesion absorption, and incidence of adverse reactions. Results After 12 and 18 months of treatment, Group A showed a higher conversion rate of mycobacterium tuberculosis-negative sputum culture and better pulmonary lesion absorption than Group B （P 〈 0. 05 ）. During the treatment, the two groups exhibited no statistically significant difference in the incidence of adverse reactions （ P 〉 0. 05 ）, and the adverse reactions were relieved after symptomatic treatments. Conclusion Combination therapy with rifabutin and moxifloxacin effectively could enhance the conversion rate of mycobacterium tuberculosis-negative sputum culture and pulmonary lesion absorption and show good safety profiles.