阿米卡星与卷曲霉素治疗耐多药肺结核的临床效果及安全性对比

Comparison of clinical effect and safety of amikacin and capreomycin in the treatment of multi-drug resistant pulmonary tuberculosis

目的对比阿米卡星与卷曲霉素治疗耐多药肺结核患者的临床效果及安全性。方法78例耐多药肺结核患者,应用摇骰子法分为参照组与治疗组,每组39例。参照组患者应用卷曲霉素进行治疗,治疗组患者应用阿米卡星进行治疗。比较两组患者的治疗效果、不良反应发生情况及治疗后炎症指标[白细胞介素-1(IL-1)、白细胞介素-6(IL-6)以及肿瘤坏死因子-α(TNF-α)]水平。结果治疗组患者治疗优良率为94.87%,高于参照组的79.49%,差异具有统计学意义(P<0.05)。治疗组患者不良反应发生率为5.13%,低于参照组的23.08%,差异具有统计学意义(P<0.05)。治疗后,治疗组患者IL-1、IL-6、TNF-α水平分别为(18.17±3.13)、(146.61±11.22)、(82.41±7.91)pg/ml,均低于参照组的(26.39±4.25)、(195.79±16.52)、(117.31±10.92)pg/ml,差异具有统计学意义(P<0.05)。结论阿米卡星治疗耐多药肺结核患者能够提高临床效果,减少不良反应发生,降低炎症反应,促进患者快速恢复,临床应用价值高。

Objective To compare the clinical effect and safety of amikacin and capreomycin in the treatment of multi-drug resistant pulmonary tuberculosis.Methods A total of 78 patients with multi-drug resistant pulmonary tuberculosis were divided into control group and treatment group by rolling the dice,with 39 cases in each group.Patients in the control group were treated with capreomycin,and patients in the treatment group were treated with amikacin.The therapeutic effect,occurrence of adverse reactions,and inflammatory indicators[(interleukin-1(IL-1),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)]after treatment were compared between the two groups.Results The excellent and good rate in the treatment group was 94.87%,which was higher than 79.49%in the reference group,and the difference was statistically significant(P<0.05).The incidence of adverse reactions in the treatment group was 5.13%,which was lower than 23.08%in the reference group,and the difference was statistically significant(P<0.05).After treatment,the levels of IL-1,IL-6,and TNF-αin the treatment group were(18.17±3.13),(146.61±11.22),and(82.41±7.91)pg/ml,which were lower than(26.39±4.25),(195.79±16.52),(117.31±10.92)pg/ml in the reference group,and the difference was statistically significant(P<0.05).Conclusion Amikacin in the treatment of multi-drug resistant pulmonary tuberculosis can significantly improve the excellent and good rate of treatment,reduce the occurrence of adverse reactions and promote the recovery of patients.It has high clinical application value.