吡嗪酰胺与左氧氟沙星联用治疗耐多药肺结核的效果观察

Therapeutic effects of pyrazinamide combined with levofloxacin on multi-drug resistant tuberculosis

目的:探讨耐多药肺结核患者联合应用吡嗪酰胺与左氧氟沙星治疗的效果。方法:抽取2017年8月至2019年7月在枣庄市肿瘤医院治疗的126例耐多药肺结核患者,采取随机数字表法将其分为对照组与观察组,每组63例。对照组采取常规抗结核+左氧氟沙星治疗,观察组在对照组治疗基础上联合吡嗪酰胺治疗。比较两组患者免疫功能、肺功能与疾病转归指标。结果:治疗后,观察组免疫球蛋白A、免疫球蛋白G、免疫球蛋白M、最大呼气流量、第1秒用力呼气容积、FEV1占预计值百分比水平均高于对照组(P均<0.05);观察组患者的病灶吸收率为92.06%(58/36),痰菌转阴率为92.06%(58/63),空洞闭合率为87.30%(55/63),对照组患者分别为76.19%(48/63)、76.19%(48/63)、69.84%(44/63),差异有统计学意义(P<0.05)。结论:吡嗪酰胺联合左氧氟沙星治疗治疗耐多药肺结核,可提高治疗效果,改善患者机体免疫功能及肺功能。

Objective:To investigate the therapeutic effects of pyrazinamide combined with levofloxacin on patients with multi-drug resistant tuberculosis.Methods:A total of 126 patients with multi-drug resistant tuberculosis treated in Zaozhuang Cancer Hospital from August 2017 to July 2019 were selected and divided into the control group and the observation groups by random number table method,with 63 cases in each group.The control group was treated with conventional anti-tuberculosis combined with levofloxacin.The observation group was given pyrazinamide on the basis of treatment for the control group.The related indicator of immune function,lung function and disease outcome of the two groups were compared.Results:After treatment,levels of immunoglobulin A,immunoglobulin G,immunoglobulin M,peak expiratory flow,forced expiratory volume in 1 second(FEV1)and percentage of FEV1 of the observation group were significantly higher than those of the control group(all P<0.05).The lesion absorption rate,negative conversion rate of sputum bacteria and cavity closure rate of the observation group were 92.06%(58/63),92.06%(58/63)and 87.30%(55/63),respectively;and these indicators of the control group were 76.19%(48/63),76.19%(48/63)and 69.84%(44/63),respectively;moreover,the difference in these indicators between the two groups was significant(P<0.05).Conclusions:Pyrazinamide combined with levofloxacin,in the treatment of multi-drug resistant tuberculosis,can improve the therapeutic effect,patient’s body immunity and lung function.