左旋氧氟沙星与吡嗪酰胺治疗肺结核合并2型糖尿病近期疗效及安全性分析  

Short-term efficacy and safety of levofloxacin and pyrazinamide in treatment of newly diagnosed pulmonary tuberculosis complicated with type 2 diabetes mellitus

作　　者：叶璐 甘能金 

机构地区：[1]马鞍山第四人民医院结核科,安徽马鞍山243000

出　　处：《临床肺科杂志》2017年第9期1659-1662,共4页Journal of Clinical Pulmonary Medicine

摘　　要：目的探讨左旋氧氟沙星与吡嗪酰胺治疗初治肺结核合并2型糖尿病的近期疗效及安全性。方法将120例初治肺结核合并2型糖尿病患者随机均分为A、B、C三组,A组选用左旋氧氟沙星(Lfx),B组选用吡嗪酰胺(Z),C组二者皆选,分别给予3HRELfx/9HR、3HREZ/9HR、3HREZLfx/9HR的抗结核方案治疗,观察三组抗结核疗效与药物不良反应。结果抗结核治疗效果:A、B两组差异无统计学意义(P>0.05),C组痰菌转阴率和病灶总吸收率在治疗开始后的前1-3个月明显优于A、B组(P<0.05),后无明显差异(P>0.05);药物不良反应发生率:B、C组明显高于A组(P<0.01),B、C组组间差异不明显(P>0.05)。结论采用左旋氧氟沙星联合吡嗪酰胺治疗,可加速痰菌转阴和病灶吸收,但单用左旋氧氟沙星时药物不良反应发生率最低,临床上可根据具体情况选择合适的个体化治疗方案。Objective To investigate the short-term efficacy and safety of levofloxacin and pyrazinamide in treatment of pulmonary tuberculosis complicated with type 2 diabetes mellitus. Methods 120 patients with pulmonary tuberculosis and type 2 diabetes were randomly divided into the A,B and C groups. Three groups were given different treatment options,Group A with 3HRELfx/9HR therapy,Group B with 3HREZ/9HR therapy and Group C with 3HREZLfx/9HR therapy. And observed the effect of three groups of anti-tuberculosis and drug adverse reactions. Results The results of anti-tuberculosis treatment showed that there was no significant difference between the group A and the group B( P > 0. 05). The rate of sputum negative conversion and total absorption of group C was significantly better than that of group A in 1 to 3 months after treatment( P < 0. 05). The incidence of drug adverse reactions in the groups B and C was significantly higher than that in the group A( P < 0. 01). The differences between the group B and the group C were not statistically significant( P > 0. 05). Conclusion Levofloxacin combined with pyrazinamide can accelerate the transformation of sputum negative and focal absorption,but the toxicity and side effects of levofloxacin alone are the lowest,and the incidence of drug adverse reactions is the lowest,which can be selected according to the specific situation,then an appropriate individualized treatment regimen can be chosen.

关 键 词：肺结核 糖尿病 抗结核药 左旋氧氟沙星 吡嗪酰胺 

分 类 号：R521[医药卫生—内科学] R587.1[医药卫生—临床医学]