口服利奈唑胺在治疗耐药结核中疗效及安全性临床观察

Clinical observation of curative effect and safety of oral linezolid in treatment of multi-drug resistant tuberculosis

目的对口服利奈唑胺在治疗耐药结核病中疗效及安全性进行系统评估。方法将我院收治的45例耐多药结核病/广泛耐药结核病患者随机分为对照组(共27例)实验组(共18例),对照组给予多药联合化疗,而实验组在对照组多药联合化疗基础上加用利奈唑胺片口服,排除非医疗因素干扰中断治疗及因药物副作用不能耐受的患者,实验组加用利奈唑胺口服至少10个月,如治疗过程因不良反应出现利奈唑胺减量,则治疗时间延长到16个月。对比两组患者临床疗效及不良反应发生率。结果实验组患者临床病症改善情况、空洞闭合率以及痰菌转阴率均较对照组有明显提高,两组比较差异有统计学意义(P<0.05),实验组患者药物不良反应发生率高于多药联合对照组,差异有显著性(P<0.05)。结论口服利奈唑胺治疗耐药结核病临床疗效显著,配合减量及支持治疗后不良反应可控,值得临床推广。

Objective To assess the efficacy and safety of oral linezolid in treatment of multi-drug resistant tuberculosis. Methods In our hospital, 45 cases of multi-drug resistant tuberculosis/extensively drug-resistant tuberculosis patients were randomly divided into the experimental group （18 cases） and the control group （27 cases）. The control group was given combined chemotherapy, and the experimental group was given linezolid oral administration based on combined chemotherapy. The experimental group were treated with oral linezolid for at least 10 months unless patients intolerance or interference by non medical factors. The additional adverse drug reaction would lead to a reduction of oral medication, and the treatment time would be prolonged to 16 months. The incidence of adverse re- actions and clinical efficacy between the two groups were compared. Results Their clinical symptoms, cavity closure and sputum changes in the experimental group were superior to the control group （ P 〈 0. 05 ）, and the incidence of drug adverse reaction in the experimental group were higher than that in the control group （ P 〈 0. 05 ）. Conclusion Oral linezolid for the treatment of drug-resistant tuberculosis has a remarkable clinical efficacy. If the patient can not tolerate, reduction and support treatment can allow patients to continue to maintain, which is worthy of wide clinical promotion.