阿莫西林/克拉维酸钾联合常规抗结核药治疗耐多药肺结核的疗效观察  

Observation of Amoxycillin/Clavulanate Potassium Combined with Conventional Anti-TB Drugs in Treatment of Multidrug Resistance Tuberculosis

作　　者：郭蕊[1] 焦雪峰[1] 陈爽[1] 罗琳[1] 

机构地区：[1]河南省胸科医院药剂科,河南郑州450000

出　　处：《中国医院用药评价与分析》2015年第9期1142-1144,共3页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：常州四药临床药学科研基金(No.CZSYJJ14009)

摘　　要：目的:探讨阿莫西林/克拉维酸钾联合常规抗结核药治疗耐多药肺结核(multidrug resistance tuberculosis,MDR-TB)的临床疗效和不良反应。方法:将205例MDR-TB患者按随机数字表法分为观察组103例和对照组102例。对照组患者给予吡嗪酰胺、乙胺丁醇、对氨基水杨酸异烟肼、利福喷丁和左氧氟沙星,观察组患者在对照组治疗的基础上加用阿莫西林/克拉维酸钾,2组疗程均为12个月。观察患者的痰菌阴转、病灶吸收、空洞闭合和不良反应发生情况。结果:治疗3个月后,2组患者痰菌阴转率的差异无统计学意义(P>0.05);治疗6、9、12个月后,观察组患者痰菌阴转率分别为68.93%(71/103)、74.76%(77/103)和81.55%(84/103),均明显高于对照组的50.98%(52/102)、55.88%(57/102)和60.78%(62/102),差异有统计学意义(P<0.05);疗程结束时观察组与对照组患者的病灶吸收总有效率分别为88.35%(91/103)和66.67%(68/102),空洞闭合总有效率分别为84.47%(87/103)和64.71%(66/102),观察组均明显优于对照组,差异均有统计学意义(P<0.05)。结论:阿莫西林/克拉维酸钾联合常规抗结核药治疗MDRTB安全、有效,但短期疗效优势不明显。OBJECTIVE： To probe into the clinical efficacy and adverse drug reaction of amoxycillin / clavulanate potassium combined with conventional anti- TB drugs in treatment of multidrug resistance tuberculosis（ MDR-TB）.METHODS： 205 MDR-TB patients were divided into treatment group（ 103 patients） and control group（ 102 patients）by random number table. The control group was given amoxycillin,ethambutol,isoniazid aminosalicylate,rifapentine and levofloxacin,the observation group received amoxycillin / clavulanate potassiumthe based on the same treatment regimen of the control group. The treatment course of 2 groups was 12 months. The changes of sputum negative conversion,focal absorption,cavity,the improved clinical symptoms and negative ADR consequences were closely observed in two groups. RESULTS： After the treatment of 3 months,there was no statistically significant difference of the sputum negative conversion rate in 2 groups（ P 0. 05）. In the treatment group,the sputum negative rate at the sixth,ninth and twelfth month were respectively 68. 93%（ 71 /103）,74. 76%（ 77 /103） and 81. 55%（ 84 /103）,which was significantly higher than that in the control group 50. 98%（ 52 /102） 、55. 88%（ 57 /102） and 60. 78%（ 62 /102） respectively,with statistically significant difference（ P 0. 05）. At the end of the treatment,the focal absorption rate of treatment group and control group was respectively 88. 35%（ 91 /103） and 66. 67%（ 68 /102）,the cavity closure rate of treatment group and control group were respectively 84. 47%（ 87 /103） and 64. 71%（ 66 /102）;the above-mentioned indexes in the treatment group were all significantly better than that in the control group,with significant difference（ P 0. 05）. CONCLUSIONS： It is safe and effective to use amoxycillin / clavulanate potassium in the treatment of MDR-TB,but still have few significant advantages in the short-term efficacy.

关 键 词：阿莫西林/克拉维酸钾 耐多药肺结核 痰菌阴转率 病灶吸收 空洞闭合 

分 类 号：R974[医药卫生—药品]