莫西沙星联合卷曲霉素治疗耐多药肺结核患者的效果

Effect of Moxifloxacin Combined with Capreomycin on Multi-drug Resistant Pulmonary Tuberculosis Patients

目的:观察莫西沙星联合卷曲霉素对耐多药肺结核患者的效果。方法:选取2020年3月—2023年1月龙岩市第二医院收治的80例耐多药肺结核患者,按照随机数表法分为研究组和对照组,各40例。对照组采用卷曲霉素治疗,研究组在对照组的基础上联用莫西沙星。比较两组的临床疗效、肺功能指标、免疫功能指标、炎症指标及临床症状改善情况。结果:研究组病灶总吸收率高于对照组,差异有统计学意义(P<0.05)。研究组病灶空洞总闭合率高于对照组,差异有统计学意义(P<0.05)。治疗前,两组降钙素原(PCT)、C反应蛋白(CRP)、白细胞计数(WBC)水平比较,差异无统计学意义(P>0.05);治疗后3 d,两组PCT、CRP和WBC水平均低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05)。治疗前,两组第1秒用力呼气容积(FEV_(1))、FEV_(1)占用力肺活量(FVC)的百分比(FEV_(1)/FVC%)比较,差异无统计学意义(P>0.05);治疗后3 d,两组FEV_(1)、FEV_(1)/FVC%均高于治疗前,且研究组高于对照组,差异有统计学意义(P<0.05)。治疗前,两组γ干扰素(IFN-γ)、miRNA-99b、腺苷脱氨酶(ADA)水平比较,差异无统计学意义(P>0.05);治疗后3 d,两组IFN-γ水平高于治疗前,miRNA-99b、ADA水平低于治疗前,且研究组IFN-γ水平高于对照组,miRNA-99b、ADA水平低于对照组,差异有统计学意义(P<0.05)。治疗前,两组日咯血量与日排痰量比较,差异无统计学意义(P>0.05);治疗后3 d,两组日咯血量与日排痰量低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05)。结论:莫西沙星联合卷曲霉素治疗耐多药肺结核效果较好,可有效缓解患者临床症状,抑制炎症反应,改善其肺功能和免疫功能。

Objective:To observe the effect of Moxifloxacin combined with Capreomycin on patients with multi-drug resistant pulmonary tuberculosis.Method:A total of 80 patients with multi-drug resistant pulmonary tuberculosis admitted to the Second Hospital of Longyan from March 2020 to January 2023 were selected and divided into study group and control group according to random number table method,with 40 cases in each group.The control group was treated with Capreomycin,and the study group was treated with Moxifloxacin on the basis of control group.The clinical efficacy,lung function index,immune function index,inflammation index and clinical symptom improvement of the two groups were compared.Result:The total lesion absorptivity of the study group was higher than that of the control group,and the difference was statistically significant(P<0.05).The total closure rate of focal cavity in the study group was higher than that in the control group,and the difference was statistically significant(P<0.05).Before treatment,there were no significant differences in the levels of procalcitonin(PCT),C-reactive protein(CRP)and white blood cell count(WBC)between the two groups(P>0.05).At 3 d after treatment,PCT,CRP and WBC levels in two groups were lower than those before treatment,and the study group were lower than those in the control group,the differences were statistically significant(P<0.05).Before treatment,there were no significant differences in forced expiratory volume in one second(FEV_(1)),FEV_(1)/forced vital capacity(FVC)(FEV_(1)/FVC%)between the two groups(P>0.05).At 3 d after treatment,FEV_(1) and FEV_(1)/FVC%in both groups were higher than those before treatment,and the study group were higher than those in the control group,the differences were statistically significant(P<0.05).Before treatment,there were no significant differences in the levels of interferon-γ(IFN-γ),miRNA-99b and adenosine deaminase(ADA)between two groups(P>0.05).At 3 d after treatment,IFN-γlevels in two groups were higher than those before treatment,miRNA-99b and ADA levels were lower than those before treatment,and IFN-γlevels in study group was higher than that in control group,miRNA-99b and ADA levels were lower than those in control group,the differences were statistically significant(P<0.05).Before treatment,there were no significant differences in the daily hemoptysis and daily sputum excretion between the two groups(P>0.05).At 3 d after treatment,the daily hemoptysis and daily sputum excretion in the two groups were lower than those before treatment,and the study group were lower than those in the control group,the differences were statistically significant(P<0.05).Conclusion:Moxifloxacin combined with Capreomycin is effective in the treatment of multi-drug resistant pulmonary tuberculosis,which can effectively relieve the clinical symptoms,inhibit the inflammatory response,and improve the lung function and immune function.