左氧氟沙星序贯治疗Ⅲa型前列腺炎的疗效  

Clinical efficacy of sequential therapy of levofloxacin for type Ⅲa prostatitis

作　　者：苗佩宏[1] 胡忠杰[1] 成杰[2] 沈贞佩 

机构地区：[1]武警浙江省总队嘉兴医院药械科,浙江嘉兴314000 [2]武警新疆总队医院药局 [3]武警浙江省总队嘉兴医院泌尿外科,浙江嘉兴314000

出　　处：《上海医学》2017年第10期624-627,共4页Shanghai Medical Journal

基　　金：浙江省药学会医院药学科研专项基金项目资助(2012ZYY32)

摘　　要：目的评价左氧氟沙星序贯治疗Ⅲa型前列腺炎的临床疗效和安全性,为临床制定合理用药方案提供参考。方法筛选出316例Ⅲa型前列腺炎患者,采用信封法将所有患者随机分为左氧氟沙星序贯治疗组(序贯组)和左氧氟沙星对照组(对照组),每组158例。序贯组给予静脉注射乳酸左氧氟沙星氯化钠注射液500mg,每日1次,7d后改为口服左氧氟沙星片500mg,每日1次;对照组给予静脉注射乳酸左氧氟沙星氯化钠注射液500mg,每日1次;两组均同时口服盐酸坦索罗辛缓释胶囊0.2mg,每日1次。两组疗程均为8周。分别记录治疗前和治疗8周后两组患者的美国国立卫生研究院慢性前列腺炎症状评分(NIH-CPSI)总分(包括疼痛或不适评分、排尿评分、生活质量评分)和实验室检查前列腺按摩液(EPS)中白细胞计数。评价疗效和观察不良反应发生情况。结果两组治疗8周后患者的疼痛或不适症状评分、排尿症状评分、生活质量评分和NIH-CPSI总分均显著低于同组治疗前(P值均<0.05)。两组间治疗前和治疗8周后患者的疼痛或不适症状评分、排尿症状评分、生活质量评分和NIH-CPSI总分的差异均无统计学意义(P值均>0.05)。序贯组治疗前和治疗8周后EPS中白细胞计数分别为(68.9±9.6)和(13.2±3.5)个/高倍视野,对照组分别为(69.4±9.5)和(12.9±3.1)个/高倍视野。序贯组和对照组治疗8周后EPS中白细胞计数均显著少于同组治疗前(P值均<0.05),两组间治疗前和治疗8周后EPS中白细胞计数的差异均无统计意义(P值均>0.05)。两组间治疗总有效率的差异无统计学意义(P>0.05)。序贯组不良反应发生率显著低于对照组(P<0.05)。结论左氧氟沙星序贯治疗与左氧氟沙星静脉注射治疗Ⅲa型前列腺炎的临床疗效相似,但比左氧氟沙星静脉注射治疗更具显著的安全性,用药依从性高,是Ⅲa型前列腺炎有效、合理的药物治疗方案。Objective To evaluate the efficacy and safety of sequential therapy of levofloxacin for type Ⅲa prostatitis, in order to offer a rational drug regimen in clinic. Methods A total of 316 inpatients with type Ⅲa prostatitis were enrolled in this study and randomized to administer with either levofloxacin 500 mg for intravenous drip daily for 56 days （n = 158, control group） or levofloxacin 500 mg for intravenous drip daily for 7 days followed by oral levofloxacin 500 mg daily for 49 days（n = 158, sequential group）. Moreover, tamsulosin sustained release capsule （0,2 mg） was given orally every day in both groups. Symptom scores including pain and discomfort score, urination score, quality of life score, National Institutes of Health-Chronic Prostatitis Symptom Index （NIH-CPSI） and white blood cell （WBC） count in expressed prostatic secretion （EPS） were recorded before treatment and after 8-week treatment. Clinical results and adverse reactions were evaluated. Results The symptom scores were significantly decreased in both groups at 8 weeks after treatment （all P〈0.05）. EPS-WBC count at 8 weeks after treatment was significantly less than that before treatment in the sequential group （[13.2± 3.5]/high power field （HPF） vs. [68.9 ± 9.6]/HPF） and control group （[12. 9 ± 3. ]/HPF vs. [69.4 ± 915]/HPF, both P〉0.05）. However, there were no significant differences in the symptom scores or EPS-WBCcount between two groups either before treatment or after 8-week treatment （all P〉0. 05）. Neither was the clinical effective rate between the two groups （P〈0.05）. The incidence of adverse reactions in the sequential group was significantly lower than that in the control group （P〈0.05）. Conclusion The sequential therapy of levofloxacin can achieve similar clinical efficacy of mono-therapy in the treatment of type Ⅲ a prostatitis, but it has less adverse reactions and higher medication compliance.

关 键 词：左氧氟沙星 Ⅲa型前列腺炎 序贯治疗 

分 类 号：R697.33[医药卫生—泌尿科学]