两种抗生素治疗方案对耐多药肺结核患者的疗效

Efficacy of two antibiotic regimens on patients with multi-drug resistant tuberculosis

目的:对比分析两种抗生素治疗方案对耐多药肺结核(MDR-TB)患者的疗效。方法:MDR-TB患者1500例进行规范化抗结核治疗,并按抗生素治疗方案的不同分为莫西沙星组(n=872.和左氧氟沙星组(n=628),对比两组疗效及痰菌阴转情况、空洞变化及不良反应发生率。结果:莫西沙星组总有效率为87.73%,高于左氧氟沙星组的81.21%(P<0.001);治疗3、6、9、12个月时莫西沙星组痰菌阴转率均高于左氧氟沙星组(P<0.05);治疗12个月后,莫西沙星组空洞闭合、缩小患者比例高于左氧氟沙星组(P<0.05);莫西沙星组总不良反应发生率低于左氧氟沙星组(P<0.001)。结论:氟奎诺酮类药物辅助治疗MDR-TB时,应用莫西沙星或可取得更佳抗结核获益。

Aim:To analyze the efficacy of two antibiotic regimens on patients with multi-drug resistant tuberculosis(MDR-TB).Methods:A total of 1500 patients with MDR-TB were allocated into moxifloxacin group(n=872.and levofloxacin group(n=628)according to antibiotic regimens.The curative effects,situation of sputum negative conversion,incidence of cavitation and adverse reactions were compared between the two groups.Results:The total effective rate of moxifloxacin group(87.73%)was significantly higher than that of levofloxacin group(81.21%)(P<0.001).The sputum negative conversion rates in moxifloxacin group after 3,6,9 and 12 months were significantly higher than those in levofloxacin group(P<0.05).The proportions of cavity closure and reduction in moxifloxacin group were significantly higher than those in levofloxacin group(P<0.05).The incidence of adverse reactions in moxifloxacin group was significantly lower than that in levofloxacin group(P<0.001).Conclusion:The efficacy of moxifloxacin is better than levofloxacin in the treatment of MDR-TB.