环丝氨酸联合抗结核药物治疗耐多药肺结核的临床疗效及安全性探讨

Discussion on the clinical efficacy and safety of cycloserine combined with anti-tuberculosis drugs in the treatment of multidrug-resistant tuberculosis

目的探讨耐多药肺结核患者选用环丝氨酸联合抗结核药物治疗的价值。方法80例耐多药肺结核患者,按1∶1比例分为对照组及观察组,每组40例。对照组选用抗结核药物治疗,观察组在对照组的基础上选用环丝氨酸治疗。比较两组患者的临床疗效、不良反应发生率、临床指标[用力肺活量(FVC)、第1秒用力呼气容积占预计值的百分比(FEV1%)、第1秒用力呼气容积/用力肺活量(FEV1/FVC)、肿瘤坏死因子-α(TNF-α)、白细胞介素-4(IL-4)、白细胞介素-6(IL-6)]。结果观察组的总有效率为95.00%,高于对照组的77.50%,差异具有统计学意义(P<0.05)。观察组的不良反应发生率为15.00%,与对照组的10.00%比较,差异无统计学意义(P>0.05)。治疗后,观察组患者的FVC(2.02±0.41)L、FEV1%(70.84±6.76)%、FEV1/FVC(74.26±6.67)%、IL-4(62.89±5.25)pg/ml高于对照组的(1.54±0.31)L、(58.45±5.71)%、(62.34±4.62)%、(56.78±5.42)pg/ml,TNF-α(51.02±4.25)pg/ml、IL-6(92.05±10.52)pg/ml低于对照组的(62.48±6.05)、(121.69±15.25)pg/ml,差异具有统计学意义(P<0.05)。结论环丝氨酸联合抗结核药物在耐多药肺结核治疗中效果确切,值得借鉴。

Objective To discuss the value of cycloserine combined with anti-tuberculosis drugs in the treatment of multidrug-resistant tuberculosis.Methods A total of 80 patients with multidrug-resistant tuberculosis were divided into control group and observation group according to the ratio of 1:1,with 40 cases in each group.The control group was treated with anti-tuberculosis drugs,and the observation group was treated with cycloserine on the basis of the control group.Both groups were compared in terms of clinical efficacy,incidence of adverse reactions,clinical indicators[forced vital capacity(FVC),percentage of forced expiratory volume in the 1st second to predicted value(FEV1%),forced expiratory volume in the 1st second/forced vital capacity(FEV1/FVC),tumor necrosis factor-α(TNF-α),interleukin-4(IL-4),interleukin-6(IL-6)].Results The total effective rate of the observation group was 95.00%,which was higher than 77.50%of the control group,and the difference was statistically significant(P<0.05).The incidence of adverse reactions in the observation group was 15.00%,and the difference was not statistically significant compared with 10.00%in the control group(P>0.05).After treatment,the FVC(2.02±0.41)L,FEV1%(70.84±6.76)%,FEV1/FVC(74.26±6.67)%,IL-4(62.89±5.25)pg/ml of the observation group were higher than(1.54±0.31)L,(58.45±5.71)%,(62.34±4.62)%,(56.78±5.42)pg/ml of the control group;the TNF-α(51.02±4.25)pg/ml and IL-6(92.05±10.52)pg/ml of the observation group were lower than(62.48±6.05)and(121.69±15.25)pg/ml of the control group;the differences were all statistically significant(P<0.05).Conclusion Cycloserine combined with anti-tuberculosis drugs is effective in the treatment of multidrug-resistant tuberculosis,and is worthy of reference.