利奈唑胺联合方案治疗耐多药结核病效果及不良反应研究

Effects and adverse reactions of combined treatment containing linezolid on multidrug-resistant tuberculosis

目的探讨含利奈唑胺联合方案治疗对耐多药结核病患者痰菌阴转率、病灶吸收情况、空洞变化情况及不良反应的影响。方法收集2012年1月—2017年12月于我院治疗的60例耐多药结核病患者临床资料,根据治疗方案将患者分为对照组与研究组。对照组治疗方案为左氧氟沙星、阿米卡星、吡嗪酰胺、丙硫异烟胺及对氨基水杨酸。研究组治疗方案为在对照组治疗方案基础上给予利奈唑胺治疗。比较2组患者痰菌阴转率、病灶吸收情况、空洞变化情况及不良反应。结果治疗6个月,研究组痰菌阴转率与病灶吸收有效率均大于对照组(P均<0.05),空洞变化有效率及不良反应发生率与对照组无显著差异(P均> 0.05)。结论含利奈唑胺联合方案治疗可提高耐多药结核病患者痰菌阴转率和病灶吸收有效率,但易发生血小板减少,贫血等不良反应,须定期进行血常规检查。空洞变化有效率及不良反应与对照组相同。

Objective To investigate the effects of combined treatment containing linezolid on the sputum negative conversion rate,lesion absorption,void changes and adverse reactions on multidrug-resistant tuberculosis.Methods Clinical data of 60 patients with multidrug-resistant tuberculosis who were treated in our hospital from January 2012 to December 2017 were collected,and the involved patients were divided into control group and study group according to their treatment regimens.The treatment regiment in the control group was combined treatment of levofloxacin,amikacin,pyrazinamide,protionamide and paminosalicylic acid,and the study group was treated with linezolid in addition to the treatment of the control group.Sputum negative conversion rate,lesion absorption,void changes and adverse reactions were compared between 2 groups.Results After 6 months of treatment,the sputum negative conversion rate and lesion absorption rate in the study group were higher than those in the control group(P<0.05),and there were no significant differences in the effective rate of void changes and the adverse reactions between 2 groups(P>0.05).Conclusions Combined treatment containing linezolid can improve the sputum negative conversion rate and the effective rate of lesion absorption in patients with multidrug-resistant tuberculosis,but it is prone to adverse reactions such as thrombocytopenia and anemia,so regular blood routine tests are necessary.The effective rate and adverse reactions of cavity change are the same as those in the control group.