利奈唑胺联合莫西沙星和阿米卡星治疗耐药肺结核的疗效及对血清PON1活性和sTREM-1表达的影响

Efficacy of Linezolid Combined with Moxifloxacin and Amikacin in the Treatment of Drug-Resistant Pulmonary Tuberculosis and Its Effects on Activity of PON1 and Expression of sTREM-1

目的:研究利奈唑胺联合莫西沙星和阿米阿星治疗耐药肺结核的疗效及对血清对氧磷酶1(PON1)活性及可溶性髓系细胞触发受体-1(sTREM-1)表达的影响。方法:选取2019—2020年该院收治的耐药肺结核患者80例,根据治疗方案的不同,将患者分为对照组和观察组,每组40例。在基本治疗的基础上,对照组患者给予莫西沙星和阿米卡星,观察组患者在对照组的基础上联合应用利奈唑胺。比较两组患者的临床疗效、肺部病灶缩小时间、结核分枝杆菌转阴时间以及血清指标的变化。结果:治疗后,观察组患者的总有效率为90.0%(36/40),高于对照组的67.5%(27/40),差异有统计学意义(P<0.05)。治疗后,观察组患者病灶吸收时间、空洞闭合时间、抗酸染色涂片阴性时间和痰培养转阴时间均显著短于对照组,差异均有统计学意义(P<0.05)。治疗后,两组患者血清肿瘤坏死因子α和降钙素原水平均明显降低;与对照组相比,观察组患者降低更为显著,差异均有统计学意义(P<0.05)。治疗后,两组患者血清PON1活性均显著升高,且观察组患者显著高于对照组,差异均有统计学意义(P<0.05)。治疗后,两组患者血清sTREM-1的表达水平均降低,但对照组与治疗前比较差异无统计学意义(P>0.05),观察组与治疗前比较差异有统计学意义(P<0.05)。结论:利奈唑胺联合莫西沙星和阿米卡星治疗耐药肺结核,可缩短患者肺部损伤修复时间和致病结核分枝杆菌转阴时间,改善炎症水平和氧化应激水平,减轻炎症损伤,提高疗效,改善预后。

OBJECTIVE:To study the efficacy of linezolid combined with moxifloxacin and amiacin in the treatment of drug-resistant pulmonary tuberculosis,and its effects on the activity of PON1 and the expression of sTREM-1.METHODS:Totally 80 patients with drug-resistant pulmonary tuberculosis admitted into this hospital from 2019 to 2020 were extracted to be divided into control group and observation group according to different therapeutic regimens,with 40 cases in each group.On the basis of basic treatment,the control group was given moxifloxacin and amikacin,while the observation group was given linezolid based on the control group.Changes of the clinical efficacy,time of pulmonary focal shrinkage,negative conversion of mycobacterium tuberculosis and serum indicators were compared between two groups.RESULTS:After treatment,the total effective rate of the observation group was 90.0%(36/40),which was higher than that of the control group(67.5%,27/40),with statistically significant difference(P<0.05).After treatment,the times of focal absorption,cavity closure,negative acid-fast staining smear and sputum culture negative conversion of the observation group were significantly shorter than those of the control group,with statistically significant differences(P<0.05).After treatment,the serum TNF-α and PCT levels of both groups were significantly decreased;compared with the control group,the decrease was more significant in the observation group,with statistically significant differences(P<0.05).After treatment,the activity of serum PON1 of both groups were significantly increased,and that of the observation group was significantly higher than the control group,with statistically significant differences(P<0.05).After treatment,the expression level of serum sTREM-1 of both groups were significantly decreased,the difference in the control group before and after treatment was not statistically significant(P>0.05),while the difference in the observation group before and after treatment was statistically significant(P<0.05).CONCLUSIONS:The combination of linezolid with moxifloxacin and amiacin in the treatment of pulmonary tuberculosis can shorten the repair time of pulmonary damage and negative conversion time of pathogenic mycobacterium tuberculosis,improve inflammatory level and oxidative stress level,relieve inflammatory injury,promote efficacy and prognosis.