莫西沙星联合环丝氨酸治疗耐多药肺结核的临床疗效

Clinical Effect of Moxifloxacin Combined with Cycloserine on Multi-drug Resistant Tuberculosis

目的观察莫西沙星联合环丝氨酸治疗耐多药肺结核(MDR-TB)的临床疗效。方法选取2014年3月—2016年1月陕西省结核病防治院收治的MDR-TB患者120例,采用随机数字表法分为对照组与观察组,每组60例。在常规化疗方案基础上,对照组患者予以莫西沙星治疗,观察组患者在对照组基础上予以环丝氨酸治疗。比较两组患者临床疗效,治疗3、6、9、12、20个月痰菌阴转率,治疗后T淋巴细胞亚群及治疗期间不良反应发生情况。结果观察组患者临床疗效优于对照组(P<0.05)。治疗3、6、9个月两组患者痰菌转阴率比较,差异无统计学意义(P>0.05);治疗12、20个月观察组患者痰菌转阴率高于对照组(P<0.05)。治疗后观察组患者CD3+细胞计数、CD_4^+细胞计数、CD_8^+细胞计数、CD_4^+/CD_8^+细胞比值高于对照组(P<0.05)。两组患者治疗期间不良反应发生率比较,差异无统计学意义(P>0.05)。结论莫西沙星联合环丝氨酸治疗MDR-TB的临床疗效确切,可有效提高远期痰菌转阴率,改善患者免疫功能,且安全性较高。

Objective To observe the clinical effect of moxifloxacin combined with cycloserine on multi-drug resistant tuberculosis（MDR-TB）. Methods A total of 120 patients with MDR-TB were selected in Tuberculosis Prevention and Control Institute of Shaanxi Province from March 2014 to January 2016,and they were divided into control group and observation group according to random number table,each of 60 cases. Based on routine chemotherapy regimen,patients in control group received moxifloxacin,while patients in observation group received moxifloxacin combined with cycloserine. Clinical effect,sputum negative conversion rate 3 months,6 months,9 months,12 months and 20 months after treatment,T-lymphocyte subsets after treatment,and incidence of adverse reactions during treatment were compared between the twogroups. Results Clinical effect in observation group was statistically significantly better than that in control group（P〈0.05）. No statistically significant differences of sputum negative conversion rate was found between the two groups 3 months,6 months or 9 months after treatment（P〉0.05）,while sputum negative conversion rate in observation group was statistically significantly higher than that in control group 12 months and 20 months after treatment,respectively（P〈0.05）. CD3^＋ cell counting,CD4^＋ cell counting, CD8^＋ cell counting and CD4＋/CD8＋ cell ratio in observation group were statistically significantly higher than those in control group after treatment（P〈0.05）. No statistically significant differences of incidence of adverse reactions was found between the two groups during treatment（P〉0.05）.Conclusion Moxifloxacin combined with cycloserine has certain clinical effect in treating MDR-TB,can effectively improve the long-term sputum negative conversion rate and immunological function,with relatively high safety.