利奈唑胺联合环丝氨酸胶囊治疗耐多药肺结核的效果分析

Clinical effect of linezolid combined with cycloserine capsules on multidrug resistant tuberculosis

目的探讨利奈唑胺联合环丝氨酸胶囊治疗耐多药肺结核的临床效果。方法抽取2020年8月至2021年9月新乡医学院第一附属医院收治的耐多药肺结核患者98例,按随机数字表法分为观察组与对照组,每组49例。对照组采用环丝氨酸胶囊治疗,观察组在对照组基础上联合利奈唑胺治疗。对比两组临床疗效、临床症状改善时间、炎症因子水平[降钙素原(PCT)、肿瘤坏死因子-α(TNF-α)]、T淋巴细胞亚群(CD3^(+)、CD4^(+))水平、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)水平及不良反应发生率。结果观察组总有效率(95.92%,47/49)高于对照组(81.63%,40/49),P<0.05;观察组病灶吸收缩小时间、抗酸染色涂片阴性、空洞闭合时间、痰培养转阴时间均短于对照组(P均<0.05);治疗后,观察组PCT、TNF-α水平低于对照组(P<0.05);治疗后,观察组CD3^(+)、CD4^(+)水平高于对照组(P<0.05);治疗后,观察组ALT、AST水平低于对照组(P<0.05)。观察组不良反应发生率(8.16%,4/49)与对照组(6.12%,3/49)比较差异未见统计学意义(P>0.05)。结论利奈唑胺联合环丝氨酸胶囊治疗耐多药肺结核能减轻炎症反应、增强免疫功能,缩短症状改善时间,并可减轻对肝功能的影响,临床效果和安全性良好。

Objective To investigate the clinical effect of linezolid combined with cycloserine capsules on multidrug resistant tuberculosis.Methods A total of 98 patients with multidrug resistant tuberculosis treated in the First Affiliated Hospital of Xinxiang Medical University from August 2020 to September 2021 were selected,and they were divided into observation group and control group according to the random number table method,with 49 cases in each group.The control group was given cycloserine capsules,and the observation group was given linezolid based on the treatment of the control group.The clinical efficacy,clinical symptom improvement time,levels of inflammatory factors including procalcitonin(PCT)and tumor necrosis factor-α(TNF-α),levels of T lymphocyte subsets including cluster of differentiation 3^(+)(CD3^(+))and cluster of differentiation 4^(+)(CD4^(+)),levels of ammonia aminotransferase(ALT)and aspartate aminotransferase(AST),and incidence of adverse reactions were compared between the two groups.Results The total effective rate of the observation group(95.92%,47/49)was higher than that of the control group(81.63%,40/49),P<0.05.The time of the absorption and shrinkage of the lesions,time of acid-fast staining smear negative,time of cavity closure,and time of sputum culture turning negative in the observation group were shorter than those in the control group(all P<0.05).After treatment,the levels of PCT and TNF-αin the observation group were lower than those in the control group(P<0.05).After treatment,the levels of CD3^(+)and CD4^(+)in the observation group were higher than those in the control group(P<0.05).After treatment,levels of ALT and AST in the observation group were lower than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the observation group(8.16%,4/49)and the control group(6.12%,3/49),P>0.05.Conclusions Linezolid combined with cycloserine capsules in the treatment of multidrug resistant tuberculosis can alleviate inflammation,enhance immune function,shorten the time for symptom improvement,and reduce the impact on liver function,with good clinical effect and safety.