对PAS联合Lfx、Pto治疗复治结核临床疗效观察

Observation of clinical efficacy of PAS combined with Lfx and Pto in treatment of recurrent tuberculosis

目的探讨氨基水杨酸异烟肼（PAS）联合左氧氟沙星（Lfx）、丙硫异烟胺（Pro）治疗复治结核的临床疗效。方法选取我院2013年4月～2014年4月收治的结核病患者110例，随机分为研究组与对照组各55例。对照组采用对氨基水杨酸联合利福平进行治疗，研究组采用氨基水杨酸异烟肼联合左氧氟沙星、丙硫异烟胺进行治疗。结果两组患者经过2,6、12、18个月的治疗后，对照组在18个月末时转阴率为45．4％，研究组在18个月末时转阴率为85．4％。18个月疗程结束后，研究组的病灶有效率为96．3％，空洞闭合率为66．7％。空洞好转率为88．9％，未闭合的空洞也都逐渐缩小，有5例患者无变化的主要原因是空洞的直径缩小未达到1/2。对照组病灶有效率为81．8％，空洞闭合率为45．5％，空洞好转率为77．3％，疗程结束后，仍有10个空洞无变化，两组比较差异有统计学意义（P〈0．05）。结论对于结核病来说，采用氨基水杨酸异烟肼联合左氧氟沙星、丙硫异烟胺进行治疗，临床疗效较好，且安全性较高，药物产生的副作用小，值得在临床中推广应用。

Objective To explore the clinical efficacy of PAS （aminosalicylic isoniazide） combined with Lfx （lev- ofloxacin） and Pto（prothionamide） in the treatment of recurrent tuberculosis. Methods 110 patients with tuberculosis treated in our hospital from April 2013 to April 2014 were selected and randomly assigned to the study group and the control group, with 55 patients in each group. The control group was given para-aminosalicylic acid combined with ri- fampin treatment and the study group was given aminosalicylic isoniazide combined with levofloxacin and protionamide treatment. Results After 2, 6, 12 and 18 months of treatment, the negative conversion ratio at the end of 18 months in the control group was 45.4% and that in the study group was 85.4%. After 18 months of treatment, in the study group, the lesion effective rate was 96.3%, the cavity closure rate was 66.7% and the cavity improvement rate was 88.9%, the unclosed cavities were shrinking gradually, and the main cause of 5 unchanged patients was that the cavity diameter shrink did not reach 1/2. In the control group, the lesion effective rate was 81.8%, the cavity closure rate was 45.5% and the cavity improvement rate was 77.3%, and after the end of treatment course, there were still 10 unchanged cavi- ties. There existed statistically significant differences between the two groups（P〈0.05）. Conclusion For tuberculosis, the application of aminosalicylic isoniazide combined with levofloxacin and protionamide shows good clinical efficacy, high safety and small drug induced side effect, thereby worthy of clinical promotion and application.