莫西沙星联合卷曲霉素治疗耐多药肺结核54例及细胞免疫功能变化  

Efficacy and Cellular Immune Function Research of Moxifloxacin Combined with Capreomycin for Treating Multi-Drug Resistant Pulmonary Tuberculosis in 54 Cases

作　　者：温俊霞[1] 安贺娟[1] 张进明[2] 王菁[3] 

机构地区：[1]河北省胸科医院临床药学部,河北石家庄050041 [2]河北医科大学第四医院骨科,河北石家庄050011 [3]河北省石家庄市第一医院神经内科,河北石家庄050011

出　　处：《中国药业》2015年第20期26-28,共3页China Pharmaceuticals

摘　　要：目的探讨莫西沙星联合卷曲霉素治疗耐多药肺结核的临床疗效及对患者免疫功能的影响。方法选取医院收治的耐多药肺结核患者108例,按治疗方式不同分为观察组和对照组,各54例。观察组患者采用莫西沙星联合卷曲霉素化学治疗(简称化疗),对照组患者采用左氧氟沙星联合卷曲霉素化疗。结果治疗后,观察组患者外周血CD4+CD25+CD127low调节性T细胞表达水平明显低于对照组,白细胞介素(IL)-17表达水平明显高于对照组(P<0.05);观察组患者的痰菌转阴率、病灶吸收好转率和空洞缩小明显优于对照组(P<0.05),痰菌转阴时间、症状改善时间显著短于对照组(P<0.05);两组患者的不良反应发生率比较,差异无统计学意义(P>0.05)。结论莫西沙星联合卷曲霉素治疗耐多药肺结核,能有效调节CD4+CD25+CD127low调节性T细胞和IL-17表达水平,改善免疫功能,疗效显著,且不良反应少,值得临床推广。Objective To investigate the efficacy and cellular immune function of moxifloxacin combined with capreomycin in treating multi-drug resistant pulmonary tuberculosis. Methods 108 cases of patients with multi-drug resistant pulmonary tuberculosis in the hospital were selected and divided into the observation group and the control group according to different treatment methods~ The obser- vation group was treated with moxifloxacin combined with capreomycin, the control group was treated with levofloxacin combined with capreomycin. Results After the treatment,the peripheral blood CD4＋CD25＋CD127low regulatory and T cells of the observation group was significantly lower than the control group,and the IL-17 expression levels was significantly higher than the control group（P 〈 0.05）; The sputum negative conversion rate of patients, lesions improved absorption rate and cavity narrowing of observation group was signifi- cantly better than the control group（ P 〈 0. 05）. The sputum negative conversion time and symptoms improved time of observation group was significantly shorter than the control group（P 〈 0. 05）. There was no significant difference in the adverse reaction rate of the two groups（P 〉 0. 05）. Conclusion Moxifloxacin combined with capreomycin in treating multi-drug resistant pulmonary tuberculosis can effectively adjust the peripheral blood CD4＋CD25＋CD127low regulatory and T cells and IL-17 expression levels,and improve the immune function with significant efficacy and few adverse reactions, and is worthy of clinical promotion.

关 键 词：耐多药肺结核 莫西沙星 卷曲霉素 免疫功能 

分 类 号：R969.4[医药卫生—药理学] R978.69[医药卫生—药学]