含左氧氟沙星、力克肺疾、微卡方案治疗耐多药肺结核近期疗效观察

Short-term effect of treatment protocol utilizing levofloxacin, pasiniazide and M.Vaccae on multi- drug resistant pulmonary tuberculosis

目的观察含左氧氟沙星、力克肺疾、微卡联合化疗方案对耐多药肺结核(MDR-TB)的疗效。方法将97例MDR-TB患者随机分为治疗组(50例)和对照组(47例),对两组分别以不同的药物进行治疗,疗程均为6个月。观察两组痰菌阴转率、病变吸收率、空洞闭合率以及免疫功能改善情况。结果治疗组与对照组治疗后各项指标分别为:菌阴转率(84% vs42%)、病灶显效率(83% vs33%)、空洞闭合率(66% vs26%)。另外,治疗组CD3、CD4较治疗前明显升高;CD8较治疗前显著降低;CD4 / CD8比值升高。两组药物不良反应率无显著性差异(30% vs38%)。结论应用三药联合化疗方案治疗MDR-TB疗效确切,可进一步应用于临床。

Objective To observe the effects of the protocol combining levofloxacin, pasiniazide, M.Vaccae (V+D+M protocol) in the treatment of multi-drug resistant pulmonary tuberculosis (MDR-TB). Method Ninety-seven cases of MDR-TB randomized into V+D+M treatment protocol group (n=50) and control group (n=47) were observed for the negative sputum conversion rate, focal absorption, pulmonary cavity closure and improvement of immune function, after a 6-month treatment course. Results After the completion of the treatment course, the negative sputum conversion rate in V+D+M treatment protocol group was 84%, significantly higher than that in the control group (42%); the former group showed a focal absorption rate and pulmonary cavity closure rate of 83% and 66%, which were 33% and 26% respectively in the latter. In V+D+M treatment protocol group, T lymphocyte subgroups CD3 and CD4 were significantly elevated while CD8 decreased after treatment, resulting in increased CD4 to CD8 ratio. The incidence of adverse effects resulting from the different treatment protocols in the two groups were comparable (30% vs 38%). Conclusion V+D+M treatment protocol is effective for MDR-TB, which possesses the potential for application in clinical practice.