左氧氟沙星联合抗结核药对重症结核性腹膜炎患者腹腔积液及不良反应的影响

Effects of levofloxacin combined with anti-tuberculosis drugs on ascites and adverse reactions in patients with severe tuberculous peritonitis

目的 探讨左氧氟沙星联合抗结核药对重症结核性腹膜炎(TBP)患者腹腔积液及不良反应的影响。方法 选取2021年1月至12月接受诊治的120例重症TBP患者为研究对象,根据入院先后顺序将其分为对照组(60例,常规抗结核药治疗)和研究组(60例,左氧氟沙星联合常规抗结核药治疗)。比较两组的治疗效果。结果 研究组的治疗总有效率高于对照组(P<0.05)。研究组的腹胀、腹痛、腹部包块消失时间及腹水吸收时间短于对照组,腹腔积液抽吸次数少于对照组(P<0.05)。治疗后,两组的腺苷脱氨酶(ADA)、乳酸脱氢酶(LDH)、癌抗原125(CA125)、降钙素原(PCT)水平均降低,且研究组低于对照组(P<0.05)。治疗后,两组的谷丙转氨酶(ALT)、谷草转氨酶(AST)、血肌酐(Scr)水平均高于治疗前,差异具有统计学意义(P<0.05)。两组的不良反应总发生率无显著差异(P>0.05)。结论 左氧氟沙星联合抗结核药能改善重症TBP患者的临床症状,减少腹腔积液,且对肝肾功能影响小,不会增加不良反应,疗效较佳。

Objective To explore the effects of levofloxacin combined with anti-tuberculosis drugs on ascites and adverse reactions in patients with severe tuberculous peritonitis(TBP).Methods A total of 120 patients with severe TBP who were diagnosed and treated from January to December 2021 were selected as the research objects.According to the order of admission,the patients were divided into control group(60 cases,conventional anti-tuberculosis drugs treatment)and study group(60 cases,levofloxacin combined with conventional anti-tuberculosis drugs treatment).The therapeutic effects of the two groups were compared.Results The total effective rate of treatment in the study group was higher than that in the control group(P<0.05).The disappearance time of abdominal distension,abdominal pain,abdominal mass and ascites absorption time in the study group were shorter than those in the control group,and the number of ascites aspiration was less than that in the control group(P<0.05).After treatment,the levels of adenosine deaminase(ADA),lactate dehydrogenase(LDH),cancer antigen 125(CA125)and procalcitonin(PCT)in the two groups decreased,and those in the study group were lower than the control group(P<0.05).After treatment,the levels of alanine transaminase(ALT),aspartate aminotransferase(AST)and serum creatinine(Scr)in the two groups were higher than those before treatment,and the differences were statistically significant(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion Levofloxacin combined with anti-tuberculosis drugs can improve the clinical symptoms of patients with severe TBP,reduce ascites,and has little effect on liver and kidney function.It will not increase adverse reactions,and has better curative effect.