含左氧氟沙星化疗方案治疗复治涂阳肺结核的临床效果

Clinical efficacy on chemotherapy regimens with Levofloxacin for retreatment of smear-positive pulmonary tuberculosis

目的探讨含左氧氟沙星化疗方案治疗复治涂阳肺结核的临床效果。方法选取浙江省台州市立医院2012年9月~2015年1月肺结核门诊诊断复治涂阳肺结核患者,入组116例,随机分成两组,每组58例,共脱落19例,完成疗程97例,实验组49例,对照组48例;实验组(含左氧氟沙星化疗方案):3HRZELfx/5HRLfx。对照组(标准化疗方案):2HRZESm/6HRE。观察临床疗效、痰菌转阴率、胸部CT疗效、不良反应,8个月疗程结束后进行疗效评定。结果实验组总有效率为97.96%,对照组总有效率为83.33%,两组临床疗效比较,差异有统计学意义(P<0.05),显示实验组临床疗效优于对照组。痰菌阴转率:实验组痰菌阴转率为97.96%,对照组痰菌阴转率为81.25%。两组痰菌阴转率比较,差异有统计学意义(P<0.05),显示痰菌转阴率实验组要好于对照组。胸部CT疗效:实验组总有效率为95.92%,对照组总有效率为81.25%,两组胸部CT疗效比较,差异有统计学意义(P<0.05),显示实验组胸部CT疗效优于对照组。实验组不良反应5例,对照组不良反应15例,两组不良反应比较,差异有统计学意义(P<0.05),显示实验组治疗能明显减少患者的不良反应。结论含左氧氟沙星化疗方案的治疗下,复治涂阳肺结核患者在临床疗效、胸部CT疗效、痰菌阴转率均优于标准化疗方案,而不良反应发生率低于标准化疗方案。

Objective To explore the clinical efficacy on chemotherapy regimens with Levofloxacin for retreatment of smear-positive pulmonary tuberculosis. Methods 116 patients with retreatment of smear-positive pulmonary tuberculosis in Zhejiang Taizhou Municipal Hospital from September 2012 to January 2015 were selected and randomly divided into the trial group(49 cases) and the control group(48 cases), a total of 19 cases fell off and 97 cases completed the treatment. The trial group were treated with 3HRZELfx/5HRLfx plan. The control group were treated with 2HRZESm/6HRE plan. The treatment efficacy were evaluated after the end of 8 months by observing the clinical efficacy, the sputum negative conversion rate, chest CT efficacy, adverse reaction. Results The total effective rate of the trial group was 97.96%, while the control group’s total effectiveness was 83.33%. Comparing the two groups, it was found that there were statistically significant differences(P < 0.05). The results showed that the clinical efficacy of the trial group was better than that of the control group. Sputum negative conversion rate: the trial group was 97.96%, while the control group was 81.25%. Comparing the two groups, it was found that there were statistically significant differences(P <0.05). The results showed that the sputum negative conversion rate of the trial group was better than that of the control group. Chest CT efficacy: the total effective rate of the trial group was 95.92%, while the control group was 81.25%.Comparing the two groups, it was found that there were statistically significant differences(P < 0.05).The results showed that the efficacy of chest CT the trial group was better than that of the control group. Adverse reaction: 5 cases of adverse reactions were found in the trial group, 15 cases of adverse reactions were found in the control group. Comparing the two groups, it was found that there were statistically significant differences(P < 0.05),which showed that the trial group could significantly reduce the adverse reactions of patients. Conclusion With the treatment of Levofloxacin chemotherapy regimen, the clinical efficacy, chest CT efficacy and sputum negative conversion rate of the patients with retreatment smear-positive pulmonary tuberculosis are superior to those of the standard chemotherapy regimens, but the adverse reaction rate is lower than that of the standard chemotherapy regimens.