含克拉霉素化疗方案在耐多药肺结核治疗中的应用价值及近期疗效分析

Curative efficacy of Chemotherapy regimen containing clarithromycin in treatment of Multi-drug resistant tuberculosis

目的 :探讨含克拉霉素化疗方案治疗耐多药肺结核的临床疗效分析。方法 :选择2012年6月1日～2012年12月31日到我院住院治疗的、确诊登记的72例耐多药肺结核病连续病例为研究对象。采用随机、平行对照研究,以我院院为单位按流水号排序,采取简单随机分组方法,单号为研究组,双号为对照组,每组各36例患者。研究组采用含克拉霉素化疗方案进行治疗,对照组采用标准化疗方案进行治疗。比较两组临床疗效、痰菌转阴情况、病灶吸收情况、空洞闭合情况、不良反应及生存率。结果 :研究组总有效率略高于对照组,但无统计学意义[66.67%(24/36)vs 55.56%(20/36)];研究组在第3、6、9、12、18、24个月时的痰菌转阴率均略高于对照组,但差异无统计学意义;研究组患者病灶吸收总有效率高于对照组[86.11%(31/36)vs 61.11%(22/36)];研究组空洞闭合率略高于对照组,但差异无统计学意义[88.89%(32/36)vs 72.22%(26/36)];研究组不良反应总发生率低于对照组[16.67%(6/36)vs 50%(18/36)];研究组第24个月时生存率高于对照组[77.78%(28/36)vs 55.56%(20/36)]。结论 :在耐多药肺结核患者中使用含克拉霉素化疗方案效果显著,有助于提高痰菌转阴率,改善病灶及空洞情况,提高生存率,同时降低不良反应发生率,疗效确切,值得推广应用。

Objective To study curative efficacy of chemotherapy regimen containing clarithromycin in treatment of Multi-drug resistant tuberculosis.Methods 72 patients of multidrug resistant pulmonary tuberculosis who received therapy from Jun 1,2012 to Dec 31,2012 in our hospital.A randomized,parallel-controlled study was conducted in our hospital based on serial numbers.A simple randomization method was used.The single number was study group and the double number was control group with 36 patients in each group.The study group was treated with clarithromycin chemotherapy and the control group was treated with standard chemotherapy regimen.Clinical efficacy,sputum negative conversion,lesion absorption,empty closure,adverse reactions and survival rate were compared between the two groups.Results The total effective rate of the study group was slightly higher than that of the control group,but not statistically significant[67%(24/36)vs 56%(20/36)];The sputum negative rate of the study group at 3,6,9,12,12,18 and 24 months was slightly higher than that of the control group,but the difference was not statistically significant;The total effective rate of lesion absorption in study group was higher than that in control group[86.11%(31/36)vs 61.11%(22/36)];The closure rate of the study group was slightly higher than that of the control group,but the difference was not statistically significant[88.89%(32/36)vs72.22%(26/36)];The total incidence of adverse reactions in the study group was lower than that in the control group[16.67%(6/36)vs 50%(18/36))];The study group at 24 months survival rate was higher than the control group[77.78%(28/36)vs 55.56%(20/36)].Conclusion The treatment of multi-drug resistant pulmonary tuberculosis patients with clarithromycin chemotherapy can significantly improve the rate of sputum negative conversion rate,improve the lesion and cavity,improve the survival rate,reduce the incidence of adverse reactions,and have definite curative effect.It is worth to be popularized and applied.