莫西沙星联合HRZE化疗方案治疗肺结核的疗效及对血清PCT、hs-CRP水平的影响

Efficacy of Moxifloxacin Combined with HRZE Chemotherapy Regimen in the Treatment of Pulmonary Tuberculosis and its Impact on Serum PCT and hs-CRP Levels

【目的】探讨莫西沙星联合异烟肼^(+)利福平^(+)吡嗪酰胺^(+)乙胺丁醇(HRZE)化疗方案治疗肺结核的疗效及对患者血清降钙素原(PCT)、超敏C-反应蛋白(hs-CRP)水平的影响。【方法】本院收治的80例肺结核患者,随机分为观察组与对照组,每组40例。两组均采用HRZE抗结核药化疗方案治疗肺结核,观察组在此基础上加用莫西沙星治疗,两组患者均治疗4个月。比较两组治疗后痰菌转阴率及胸部CT评价情况,另比较两组PCT、hs-CRP水平、免疫功能指标[细胞毒性T细胞(CD8^(+))、辅助T细胞(CD4^(+))、免疫球蛋白G(IgG)、免疫球蛋白A(IgA)]状况及不良反应发生情况。【结果】观察组治疗后痰菌转阴率为92.50%(37/40),显著高于对照组的75.00%(30/40)(P<0.05)。观察组胸部CT总吸收率为97.5%(39/40),显著高于对照组的77.50%(31/40)(P<0.05);治疗后,两组血清PCT、hs-CRP水平显著低于治疗前(P<0.05),且观察组治疗后血清PCT、hs-CRP水平显著低于对照组(P<0.05);两组治疗后CD4^(+)、IgG、IgA水平显著高于治疗前,CD8^(+)水平低于治疗前,且差异有统计学意义(P<0.05),观察组治疗后IgA、CD4^(+)、IgG水平显著高于对照组,CD8^(+)水平低于对照组(P<0.05);两组治疗后不良反应总发生率比较,差异无统计学意义(P>0.05)。【结论】莫西沙星联合HRZE化疗方案治疗肺结核疗效显著,可有效提高临床疗效,增强患者免疫能力,同时安全性高,临床可推广应用。

【Objective】This study aimed to investigate the efficacy of moxifloxacin combined with isoniazid,rifampicin,pyrazinamide,and ethambutol(HRZE)chemotherapy regimen in the treatment of pulmonary tuberculosis and explore effects of the therapy on serum procalcitonin(PCT)and high-sensitivity C-reactive protein(hs-CRP)levels in patients.【Methods】A total of 80 patients with pulmonary tuberculosis admitted to our hospital were randomly divided into an observation group and a control group,with 40 patients in each group.Both groups received HRZE anti-tuberculosis chemotherapy regimen,while the observation group received additional moxifloxacin treatment.The treatment duration for both groups was 4 months.The sputum smear conversion rate and chest CT evaluation were compared between the two groups.Additionally,the levels of PCT and hs-CRP,immune function markers[CD8^(+)T cells,CD4^(+)T cells,immunoglobulin G(IgG),immunoglobulin A(IgA)],and occurrence of adverse reactions were compared between the two groups.【Results】The sputum smear conversion rate in the observation group was 92.50%(37/40),significantly higher than that in the control group(75.00%,30/40)(P<0.05).The total absorption rate on chest CT in the observation group was 97.5%(39/40),which was significantly higher than that in the control group(77.50%,31/40)(P<0.05).After treatment,the serum levels of PCT and hs-CRP in both groups were significantly lower than before treatment(P<0.05),and the observation group had significantly lower levels of PCT and hs-CRP compared to the control group(P<0.05).The levels of CD4^(+),IgG,and IgA were significantly higher,and CD8^(+)level was lower in both groups after treatment compared to before treatment,with statistical significance(P<0.05).Moreover,the observation group had significantly higher levels of IgA,CD4^(+)and IgG and lower CD8^(+)level compared to the control group(P<0.05).The overall incidence of adverse reactions after treatment showed no significant difference between the two groups(P>0.05).【Conclusion】Moxifloxacin combined with HRZE chemotherapy regimen demonstrates significant efficacy in the treatment of pulmonary tuberculosis,effectively improves clinical outcomes,enhances patient immune capacity,and is clinically safe.Therefore,it can be widely applied in clinical practice.