卷曲霉素联合左氧氟沙星治疗复治痰涂片检查阳性肺结核的效果

Effect of capreomycin combined with levofloxacin in the treatment of recurrent sputum smear positive tuberculosis

目的分析卷曲霉素联合左氧氟沙星治疗复治痰涂片检查阳性肺结核的效果。方法选择2017年1月至2018年1月我院接收并诊治的60例复治痰涂片检查阳性肺结核患者为研究对象,采用随机数字法分为单药治疗组和联合治疗组,各30例。两组患者均采用标准复治方案3HREZ/6HRE(H:异烟肼;R:利福平;E:乙胺丁醇;Z:吡嗪酰胺)进行基础治疗,此外单药治疗组给予卷曲霉素单独治疗,联合治疗组给予卷曲霉素联合左氧氟沙星治疗。比较两组患者治疗9个月后的痰菌阴转率、治疗前、治疗9个月后的肺功能指标水平、生活质量及治疗9个月后的临床疗效。结果治疗9个月后,联合治疗组患者的痰菌阴转率明显高于单药治疗组(P<0.05);治疗9个月后,两组患者PEFR、FVC、FEV1水平、功能状况、情感状况、社会和家庭、身体状况评分明显升高,且联合治疗组高于单药治疗组(P<0.05);治疗9个月后,联合治疗组的临床治疗总有效率明显高于单药治疗组(P<0.05)。结论卷曲霉素联合左氧氟沙星对复治痰涂片检查阳性肺结核患者的疗效显著。

Objective To analyze the effect of capreomycin combined with levofloxacin in the treatment of recurrent sputum smear positive tuberculosis.Methods From January 2017 to January 2018,60 patients with recurrent sputum smear positive tuberculosis admitted and treated in our hospital were selected as research objects and divided into monotherapy group and combined therapy group by random number method,with 30 cases in each group.Patients in both groups were treated with standard retreatment regimen 3HREZ/6HRE(H:isoniazid;R:rifampicin;E:ethambutol;Z:pyrazinamide)for basic treatment.In addition,the monotherapy group was given capreomycin alone,and the combined therapy group was given capreomycin combined with levofloxacin.The sputum negative conversion rates after 9 months of treatment,levels of lung function indexes,quality of life before and after 9 months of treatment and the clinical effects after 9 months of treatment were compared between the two groups.Results After 9 months of treatment,the sputum negative conversion rate in the combined therapy group was significantly higher than that in the monotherapy group(P<0.05).After 9 months of treatment,the levels of PEFR,FVC,FEV1,scores of functional status,emotional status,social and family,physical status in the two groups significantly increased,and those in the combined therapy group were significantly higher than the monotherapy group(P<0.05).After 9 months of treatment,the total effective rate of treatment in the combined treatment group was significantly higher than that in the monotherapy group(P<0.05).Conclusion Capreomycin combined with levofloxacin in the treatment of recurrent sputum smear positive tuberculosis has significant efficacy.