不同疗程阿米卡星治疗耐多药肺结核的临床疗效及其安全性分析

Analysis of clinical efficacy and safety of different treatment courses of amikacin in the treatment of multi-drug resistant tuberculosis

目的分析对耐多药肺结核患者行不同疗程阿米卡星治疗的临床疗效及其安全性。方法选取2017年10月1日~2018年12月31日期间,接受治疗的耐多药肺结核患者66例,按照随机数字法分为对照组和试验组,每组各33例。两组均进行治疗12个月,并加用阿米卡星治疗,其中对照组患者服用6个月,试验组患者服用12个月(超长疗程)。对比两组患者的治疗安全性、治疗效果以及治疗后痰涂片转阴率。结果治疗6个月时,两组临床疗效比较,差异无统计学意义(P>0.05);治疗12个月时,两组临床疗效比较,试验组较好,差异具有统计学意义(P<0.05);治疗6个月时,两组痰涂片转阴率比较,差异无统计学意义(P>0.05);治疗12个月时,两组痰涂片转阴率比较,试验组较好,差异具有统计学意义(P<0.05);治疗期间,两组耳毒性反应和肾毒性反应发生率比较,试验组较高,差异具有统计学意义(P<0.05);两组肝毒性反应和胃肠道反应发生率比较,差异无统计学意义(P>0.05)。结论对耐多药肺结核患者行超长疗程治疗阿米卡星治疗,疗效显著,并有效提升痰涂片转阴率。

Objective To analyze the clinical efficacy and safety of different treatments of amikacin in patients with multi-drug resistant tuberculosis.Methods From October 1,2017 to December 31,2018,66 patients with multi-drug resistant tuberculosis who were treated in our hospital were divided into a control group and a test group according to the random number method,33 cases in each group.Both groups received chemotherapy for 12 months and were treated with amikacin.The patients in the control group took 6 months and the patients in the test group took 12 months(ultra-long course).Compare the treatment safety,treatment effect and the negative rate of sputum bacteria after treatment between the two groups.Results At 6 months of treatment,there was no statistically significant difference in clinical efficacy between the two groups(P>0.05);at 12 months of treatment,the difference in clinical efficacy between the two groups was significant,and the test group was better,the difference was statistically significant(P<0.05);There was no statistically significant difference in sputum bacteria conversion rate between the two groups at 6 months of treatment(P>0.05);There was a significant difference between the two groups in sputum bacteria conversion rate at 12 months of treatment,And the test group is better,the difference is statistically significant(P<0.05);during treatment,the difference in the incidence of ototoxicity and renal toxicity between the two groups is significant,which is higher in the test group and the difference is statistically significant(P<0.05);There was no significant difference in the incidence of liver toxicity and gastrointestinal reaction between the two groups(P>0.05).Conclusion The treatment of amikacin with multi-drug resistant tuberculosis patients by ultra-long course of treatment has a significant effect and effectively improves the rate of sputum bacteria turning negative.