左氧氟沙星联合常规抗痨治疗艾滋病合并肺结核的效果研究

Effect study of Levofloxacin combined with conventional anti-tuberculosis therapy on AIDS complicated with tuberculosis

目的探析对艾滋病合并肺结核患者行以左氧氟沙星联合常规抗痨治疗的临床效果。方法择取阳江市公共卫生医院感染内科2014年1月~2016年12月收治的艾滋病合并肺结核患者42例,随机分成对照组和治疗组,每组各21例。对照组行常规抗痨治疗,治疗组行左氧氟沙星联合常规抗痨治疗,对两组的临床效果进行分析和比较。结果治疗组病灶吸收总有效率明显高于对照组(P<0.05);治疗组各时间点痰菌阴转率均高于对照组(P<0.05);治疗组改良MRC呼吸困难评分、1 s率、6 min步行距离均明显高于对照组,提示治疗组呼吸功能优于对照组,差异均有统计学意义(P<0.05)。治疗组不良反应发生率为42.86%,对照组不良反应发生率为38.10%,两组不良反应发生率差异无统计学意义(P>0.05)。结论对艾滋病合并肺结核患者行以左氧氟沙星联合常规抗痨治疗不仅效果良好,而且不良反应少,可作为新一代抗结核药物,特别在特殊人群结核病治疗中,具有显著临床价值。

Objective To investigate the clinical effect of Levofloxacin combined with conventional anti-tuberculosis therapy on AIDS patients with pulmonary tuberculosis.Methods A total of 42 patients with HIV-positive pulmonary tuberculosis admitted to Yangjiang Public Health Hospital from January 2014 to December 2016 were randomly divided into control group and treatment group,21 cases in each group.The control group received conventional anti-tuberculosis therapy.The treatment group was treated with Levofloxacin and routine anti-tuberculosis treatment,the clinical effect of two groups of patients were analyzed and compared.Results The total effective rate of the treatment group was significantly higher than that of the control group（P 0.05）;the sputum negative conversion rate of the treatment group was higher than that of the control group（P0.05）;the treatment group improved MRC dyspnea score,1 seconds rate,6-minute walk distance were significantly higher than that in the control group,indicated that the respiratory function of the treatment group was better than that of the control group,the differences were statistically significant（P0.05）.The incidence of adverse reactions in the treatment group was 42.86%,the incidence of adverse reactions in the control group was38.10%.There was no significant difference in the incidence of adverse reactions between the two groups（P 0.05）.Conclusion Levofloxacin combined with conventional anti-tuberculosis therapy in patients with AIDS-associated pulmonary tuberculosis is not only effective,but also has a small adverse reaction,and can be used as a new generation of anti-TB drugs,especially in the treatment of tuberculosis in special populations.