司帕沙星、母牛分枝杆菌菌苗联合治疗耐多药肺结核  

Combination therapy of sparfloxacin and mycobacterium bovis vaccine for multidrug-resistant tuberculosis

作　　者：何建 杜德兵 向启云 孟庆华 罗世珍 邱绍勤 左武[2] 陈玉龙 

机构地区：[1]湖北省宜昌市第三人民医院,宜昌443003 [2]湖北省人民医院,武汉430200

出　　处：《传染病信息》2008年第5期301-304,共4页Infectious Disease Information

基　　金：湖北省宜昌市2004年科技发展计划项目(A04303-16)

摘　　要：目的观察和评价司帕沙星、母牛分枝杆菌菌苗联合治疗耐多药肺结核病的疗效。方法将126例耐多药肺结核病例随机分为治疗组(64例)和对照组(62例)。观察治疗前后痰结核菌抗酸染色转阴、痰结核菌培养转阴、胸片X线病灶吸收、空洞闭合率、治疗前后CD4^+、CD8^+、CD4^+/CD8^+及IFN-γ变化、药物的不良反应。结果治疗6月后治疗组痰结核菌抗酸染色转阴率、痰结核菌培养阴转率、病灶吸收率、空洞闭合率与对照组比较差异有统计学意义(P<0.01)。血清CD4^+、CD8^+百分率、CD4^+/CD8^+和IFN-γ浓度治疗组治疗6个月后与治疗前比较差异有统计学意义(P<0.01)。结论应用司帕沙星、母牛分枝杆菌菌苗及其他可供使用的结核药配伍治疗耐多药结核病,能改善耐多药结核病患者的细胞免疫功能,提高耐多药结核病患者的痰结核菌抗酸染色转阴率、病灶吸收好转率、空洞闭合率,不良反应少。Objective To observe and evaluate clinical effects of sparfloxacin combined with mycobacterium bovis vaccine in the treatment of multidrug-resistant tuberculosis （ MDR-TB ）. Methods A total of 126 patients with MDR-TB were randomly divided into the treatment group（n=64） and the control group （n=62）. These makers were observed including the sputum conversion by acid-fast stain, the sputum culture negative conversion, lesion absorption rate, the cavity closure rate, the changes of the percentage of CD4^＋ and CD8^＋ T cells in sera, the ratio of CD4^＋/CD8^＋ lymphocyte, the serum level of IFN- γ and the adverse drug reaction before and after the treatment. Results After 6 months of treatment, there were significant differences between the treatment group and the control group in sputum negative conversion by acid-fast stain, the sputum culture negative rate, the pulmonary tuberculosis lesion absorption rate and the cavity closure rate（P 〈0.01）. The percentage of CD4^＋ and CD8^＋ T cells in sera, CD4^＋/CD8^＋ ratio and the serum level of IFN- γ （P〈0.01） were significantly different in the treatment group before the treatment and after six months of treatment （P〈0.01）. Conclusions Combination therapy of sparfloxacin and mycobacterium bovis vaccine for MDR-TB may enhance the cell immune responses and improve the sputum converstion by acid-fast stain, the sputum culture negative rate, lesion absorption rate and the cavity closure rate, with slight adverse reaction.

关 键 词：母牛分枝杆菌 司帕沙星 肺结核 细胞免疫 治疗 

分 类 号：R521[医药卫生—内科学]