左氧氟沙星辅助治疗耐多药肺结核的临床效果并进行药学分析

The Clinical Effect of Levofloxacin in Adjuvant Treatment of Multi-drug Resistant Tuberculosis and Its Pharmaceutical Analysis

目的探究耐多药肺结核采取左氧氟沙星辅助治疗的效果。方法方便选取该院2016年10月—2019年1月期间收治的94例耐多药肺结核患者,通过计算机表法分为试验组与参照组,每组47例。参照组患者实施抗结核类药物治疗,试验组在参照组基础上实施左氧氟沙星,对比两组患者炎性因子及免疫功能指标,经3个月、6个月、1年及2年后痰菌转阴率,不良反应发生情况及治疗效果。结果试验组患者炎性因子TNF-α为(82.26±8.27)ng/mL、IL-6为(132.63±12.16)ng/mL,低于参照组的(101.54±9.12)、(175.96±16.56)ng/mL,差异有统计学意义(t=10.736、14.459,P<0.05);试验组免疫功能指标IgG为(20.56±2.61)g/L、IgM为(3.53±0.38)g/L、IgA为(3.77±0.68)g/L高于参照组的(14.61±1.73)、(2.32±0.24)、(3.12±0.54)g/L,差异有统计学意义(t=13.027、18.457、5.132,P<0.05);试验组患者在3个月、6个月、1年及2年后的痰菌转阴率分别为36.17%、55.32%、80.85%、95.74%,高于参照组的17.02%、34.04%、57.45%、78.72%,差异有统计学意义(χ^(2)=4.414、4.304、6.034、6.114,P<0.05);试验组患者治疗总有效率为97.87%,高于参照组的78.72%,差异有统计学意义(χ^(2)=8.340,P<0.05);试验组患者不良反应发生率为6.38%,参照组为10.64%,组间差异无统计学意义(χ^(2)=0.137,P>0.05)。结论左氧氟沙星辅助治疗耐多药肺结核效果显著,可明显改善临床症状,降低炎性水平,提高免疫力及痰菌转阴率。

Objective To explore the effect of levofloxacin adjuvant therapy for multi-drug resistant tuberculosis.Methods Conveniently selected 94 patients with multi-drug resistant pulmonary tuberculosis admitted to the hospital from October 2016 to January 2019 were divided into a test group and a reference group by computer table method,with 47 cases in each group.Patients in the reference group were treated with anti-tuberculosis drugs,and the test group was treated with levofloxacin on the basis of the reference group.Inflammatory factors and immune function indexes,the sputum conversion after 3 months,6 months,1 year and 2 years Negative rate,occurrence of adverse reactions and treatment effects of the two groups were compared.Results The inflammatory factors of TNF-αin the test group was(82.26±8.27)ng/mL and IL-6 was(132.63±12.16)ng/mL,which were lower than the reference group(101.54±9.12)ng/mL and(175.96±16.56)ng/mL,the difference was statistically significant(t=10.736,14.459,P<0.05);the immune function index of the test group IgG was(20.56±2.61)g/L,IgM was(3.53±0.38)g/L,IgA was(3.77±0.68)g/L,which were higher than the reference group(14.61±1.73)g/L,(2.32±0.24)g/L,(3.12±0.54)g/L,the difference was statistically significant(t=13.027,18.457,5.132,P<0.05);the sputum conversion rate of patients in the test group after 3 months,6 months,1 year and 2 years were 36.17%,55.32%,80.85%,95.74%,respectively,which were higher than 17.02%,34.04%,57.45%,78.72%of the reference group,the difference was statistically significant(χ^(2)=4.414,4.304,6.034,6.114,P<0.05);the total effective rate of treatment in the test group was 97.87%,which was higher than 78.72%in the reference group.The difference was statistically significant(χ^(2)=8.340,P<0.05);the incidence of adverse reactions was 6.38%in the test group and 10.64%in the reference group.There was no statistically significant difference between the groups(χ^(2)=0.137,P>0.05).Conclusion Levofloxacin is effective in adjuvant treatment of multi-drug resistant pulmonary tuberculosis,which can significantly improve clinical symptoms,reduce inflammatory levels,improve immunity and sputum conversion rate.