左氧氟沙星和莫西沙星治疗耐多药肺结核临床疗效比较  

Comparison of clinical efficacy between levofloxacin and moxifloxacin in treatment of multi-drug resistant pulmonary tuberculosis

作　　者：刘智[1] 傅佳鹏[1] 杨梁梓[1] 刘志超[1] 柯学[1] 李剑[1] 傅向东[1] 李国保[1] 

机构地区：[1]深圳市第三人民医院,广东深圳518112

出　　处：《临床肺科杂志》2017年第4期711-714,共4页Journal of Clinical Pulmonary Medicine

摘　　要：目的观察并比较左氧氟沙星和莫西沙星在治疗耐多药肺结核(MDR-TB)的临床疗效。方法将90例耐多药肺结核患者随机分为对照组45例和治疗组45例。治疗方案:对照组以莫西沙星为主,联合阿米卡星、吡嗪酰胺、丙硫异烟胺、乙胺丁醇,治疗组以左氧氟沙星为主,联合用药同对照组,所有病例疗程均为24个月。结果至疗程结束,治疗成功率对照组为78.57%,治疗组为70.73%,两组差异没有统计学意义(P>0.05);病灶吸收(显吸+吸收)率,对照组为83.30%,治疗组78.04%,两组差异没有统计学意义(P>0.05);空洞缩小率对照组71.42%,治疗组63.41%,两组差异没有统计学意义(P>0.05);空洞闭合率对照组为28.57%,治疗组21.95%,两组差异没有统计学意义(P>0.05);不良反应率对照组为16.67%,治疗组14.63%,两组差异没有统计学意义(P>0.05)。结论对于耐多药肺结核,左氧氟沙星片与莫西沙星片两者在治疗耐多药肺结核中疗效相当,药品不良反应相当,经济困难的耐多药患者,药敏提示对左氧氟沙星敏感者,可选用价格更低廉的左氧氟沙星。Objective To observe and compare the clinical efficacy between levofloxacin and moxifloxacin in treatment of resistant multi-drug tuberculosis （MDR-TB）. Methods 90 patients with multi-drug resistant pulmonary tuberculosis were randomly divided into the treatment group （45 cases） and the control group （45 cases）. The con- trol group was treated with moxifloxacin, and the treatment group with levofloxacin mainly, both combined with ami- kacin, pyrazinamide, protionamide, and ethambutol for 24 months. Results At the end of treatment, the treatment success rate was 78. 57% in the control group and 70. 73% in the treatment group. Lesions absorption rate （ marked absorption and absorption） was 83.30% and 78.04% respectively in the control and the treatment group. Cavity re- ducing and closure rate were 71.42% and 28.57% in the control group, and 63.41% and 21.95% in the treatment group. The adverse reaction rate was 16. 67% in the control group, and 14. 63% in the treatment group. The results above had no statistical significance （ P 〉 0.05）. Conclusion Levofloxacin or moxifloxacin would achieve the simi- lar clinical efficacy and the adverse reaction rate in multi-drug resistant pulmonary tuberculosis treatment, but levo- floxacin may be better because its lower price for the patients suffering the economic difficulties with the positive drug susceptibility tests.

关 键 词：左氧氟沙星 莫西沙星 耐多药肺结核 

分 类 号：R521[医药卫生—内科学]