含左氧氟沙星抗结核化疗方案治疗复治涂阳肺结核合并糖尿病的疗效评价  

Clinical Analysis of Anti-tuberculosis Treatment Including Levofloxacin on Retreatment Smear-positive Tuberculosis Combined With Diabetes Mellitus

作　　者：韩庆[1] 巴清云[1] 

机构地区：[1]江苏省常州市第三人民医院肺科,江苏常州213000

出　　处：《中国继续医学教育》2017年第13期149-151,共3页China Continuing Medical Education

摘　　要：目的观察含左氧氟沙星抗结核化疗方案治疗复治涂阳肺结核合并糖尿病的临床疗效及安全性。方法选取我院收治的复治涂阳肺结核合并糖尿病患者78例作为研究对象。常规治疗组(40例)采用肺结核强化期方案治疗;左氧氟沙星组(38例)采用左氧氟沙星替代乙胺丁醇的肺结核强化期方案治疗,比较治疗期间第2、3、5、8个月末痰涂片检查结果,评估疗程结束后胸部结核病灶吸收及不良反应情况。结果两组患者治疗第2、5、8个月末痰菌转阴率对比,差异无统计学意义(P>0.05);但第3个月末时左氧氟沙星组痰茵转阴率高于常规治疗组,两组比较,差异具有统计学意义(P=0.043)。左氧氟沙星组治愈、有效和无效率分别为73.7%、18.4%和7.9%,常规治疗组治愈、有效和无效率分别为57.5%、22.5%和20.0%。疗程结束后,左氧氟沙星组36例(94.7%)病灶明显吸收,常规治疗组31例(77.5%)明显吸收,两组吸收率比较,差异具有统计学意义(P=0.029)。两组比较不良反应发生率,差异无统计学意义(P>0.05)。结论含左氧氟沙星抗结核化疗方案可以提高复治涂阳肺结核患者的第3个月末痰菌阴转率和肺部病灶吸收率,安全有效。Objective To investigate the clinical efficacy and safety of antiTB chemotherapy treatment including levofloxacin on retreatment smearpositive tuberculosis combined with diabetes mellitus. Methods 78 patients with retreatment smear positive pulmonary tuberculosis combined with diabetes mellitus were randomly divided into two groups,conventional treatment group（n=40） was given intensive phase of tuberculosis treatment and levofloxacin group（n=38） was given levofloxacin therapy. At 2, 3, 5, 8 months after treatment, the sputum smear of the two groups was detected. The tuberculosis absorption and the adverse events of the two groups were compared. Results At 2, 5, 8 months after treatment, the sputum conversion rate had no significant difference between two groups（P〉0.05）, the sputum conversion rate at 3 months had significant difference between the two groups（P=0.043）. The cure rate, effective rate and ineffective rates in the levofloxacin group were 73.7%, 18.4% and 7.9% respectively. The cure rate, effective rate and ineffective rates in the conventional treatment group were 57.5%, 22.5% and 20.0% respectively. After the course of treatment, 36 cases（94.7%） of the levofloxacin group were obviously absorbed. In the routine treatment group, 31 cases（77.5%） were obviously absorbed. The difference of absorption rate between the two groups was statistically significant（P=0.029）. There was no significant difference in the incidence of adverse reactions between two groups（P 〈0.05）. Conclusion The anti-TB chemotherapy therapy including levofloxacin on retreatment smear positive pulmonary tuberculosis has good efficacy with little adverse reactions.

关 键 词：左氧氟沙星 复治涂阳肺结核 糖尿病 

分 类 号：R587[医药卫生—内分泌] R563[医药卫生—内科学]