高龄肺结核患者药物治疗和短期治疗的效果比较

Comparison of the effect between the new and the short-term drug therapy for elderly pulmonary tuberculosis patients

目的:观察和评价以力克肺疾、利福喷丁、莫西沙星相结合的治疗方案治疗高龄肺结核患者的有效性与耐受性.方法:选取湖北省黄冈市浠水县妇幼保健院收治的>65岁的初治菌阳性的高龄肺结核患者137例作为研究对象,随机分为观察组(n=68)与对照组(n=69),观察组采用以力克肺疾、利福喷丁、莫西沙星为新的治疗方案;对照组采用2HREZ/4HR的标准短程治疗方案,比较两组治疗方案在高龄肺结核患者中的临床疗效和安全性情况.结果:观察组与对照组患者的治疗完成率分别为91.2%和69.6%,观察组明显高于对照组,差异具有统计学意义(P<0.05);在完成治疗的患者中,观察组和对照组临床症状改善情况分别为93.5%和95.8%;治疗2个月时的痰菌阴转率分别为91.9%和89.6%;治疗有效率分别为95.2%和91.7%,以上结果差异均无统计学意义(P>0.05).结论:以力克肺疾、利福喷丁、莫西沙星的治疗方案治疗高龄肺结核患者,安全性高,临床疗效确切,值得临床推广.

AIM：To observe and evaluate the efficacy and tolerance of a therapeutic schedule with pasiniazid, rifapentin, and moxifloxacin in the elderly pulmonary tuberculosis patients. METHODS：A total of 137 patients with positive bacteria sputum aged more than 65 years admitted into Maternal and Child Health Care Hospital of Xishui County, Huanggang City, Hubei Province were randomly divided into observation group and control group. There were 68 cases in the observation group and 69 cases in the control group. The observation group was treated by a therapeutic schedule containing pasiniazid, rifapentin, and moxifloxacin, and the control group was treated by 2HREZ/4HR. The clinical efficacy and safety of the two treatment regimens were compared. RESULTS： The chemotherapy completion rate of observation group was 91. 2%, which was higher than 69. 6% of the control group, with statistically significant difference （ P〈0. 05 ） . In the patients completed therapy, ameliorative rate of symptom of the observation group was 93. 5%, and that of the control group was 95. 8%; At the second months sputum conversion rate of the observation group was 91. 9%, and that of the control group was 89.6%;At the end of treatment, the effective rate of the observation group was 95.2%, and that of the control group was 91.7%, with no statistically significant difference（P〉0.05）. CONCLUSION：The therapeutic schedule with pasiniazid, rifapentin, and moxifloxacin in the elderly pulmonary tuberculosis patients has exact curative effect and relative higher security, and is worthy of clinical popularization.