含左氧氟沙星或链霉素方案对复治肺结核患者的疗效评价

Therapeutic Evaluation for levofloxacin or streptomycin in Patients with Retreated Pulmonary Tuberculosis

目的探究复治肺结核患者接受含左氧氟沙星或链霉素方案治疗的有效性以及安全性。方法选取本院2013年1月至2017年12月期间复治涂阳肺结核患者为研究对象。所有患者均接受异烟肼(H)、利福平(R)、吡嗪酰胺(Z)、乙胺丁醇(E)等常规口服药物治疗。其中,实验组240例在常规用药治疗基础上接受左氧氟沙星(Lfx)口服治疗,对照组90例则在常规用药治疗基础上接受链霉素(S)肌肉注射治疗。实验组采用2HRZE+2Lfx/6HRE治疗方案,对照组采2HRZE+2S/6HRE治疗方案,分析两组患者的治疗结果。结果实验组的痰菌阴转率(88.75%)、病灶吸收率(84.58%)、空洞闭合率(72.92%)均明显高于对照组(P<0.01);两组肺结核患者恶心呕吐、肝功能受损、神经症状、皮疹等不良反应发生率相比,差异无统计学意义。结论复治肺结核患者接受含左氧氟沙星或链霉素方案治疗,均具有一定的临床价值,而左氧氟沙星的应用,可取得更好的疗效,且用药安全性较高。

Objective To investigate the efficacy and safety of levofloxacin or streptomycin in treating retreated pulmonary tuberculosis patients.Methods The patients with retreated smear positive pulmonary tuberculosis in our hospital from January 2013 to December 2017 were selected as the research subjects.All patients received conventional medicine,such as isoniazid(H),rifampicin(R),pyrazinamide(Z),ethambutol(E).The experimental group including 240 cases were treated with levofloxacin(Lfx)tablets on the basis of conventional treatment,while the control group including 90 cases were treated with streptomycin(S)on the basis of conventional treatment.The experimental group was treated with 2HRZE+2Lfx/6HRE,while the control group was treated with 2HRZE+2S/6HRE.The treatment results of two groups were analyzed.Results The sputum negative conversion rate(88.75%),lesion absorption rate(84.58%)and cavity closure rate(72.92%)in the experimental group were significantly higher than the control group(P<0.01).There was no significant difference in the incidence of nausea and vomiting,liver dysfunction,rash,and neurological symptoms between the two groups.Conclusion It is of a positive clinical value in treating retreated pulmonary tuberculosis for levofloxacin or streptomycin.And the application of levofloxacin could achieve better efficacy and higher safety.