卷曲霉素联合左氧氟沙星治疗复治涂阳肺结核的疗效分析  

Curative effect of Curleomycin combined with Levofloxacin in the treatment of recurrent smear positive pulmonary tuberculosis

作　　者：丁月荷 李秀萍 王家红 DING Yue-he;LI Xiu-ping;WANG Jia-hong(Department of Medicalthe,Fourth People＇s Hospital of Qinghai Provinc;Department of Respiratory,Fourth People＇s Hospital of Qinghai Provinc;Department of Hemp,Fourth People＇s Hospital of Qinghai Province,Xining Qinghai 810000,China)

机构地区：[1]青海省第四人民医院医务科,青海西宁810000 [2]青海省第四人民医院呼吸科,青海西宁810000 [3]青海省第四人民医院手麻科,青海西宁810000

出　　处：《临床和实验医学杂志》2018年第17期1875-1878,共4页Journal of Clinical and Experimental Medicine

基　　金：青海省科技计划项目(编号:2014-NS-122)

摘　　要：目的观察卷曲霉素联合左氧氟沙星治疗复治痰涂片检查阳性(涂阳)肺结核的临床疗效。方法采用前瞻性随机双盲对照研究法,选取2014年1月至2016年6月青海省第四人民医院收治的120例抗酸杆菌阳性复治肺结核患者,按照随机平行分组法将患者随机分为两组,每组各60例。对照组复治方案为3SEL2Pa Z/9EL2Pa,观察组在上述复治方案的基础上加用卷曲霉素联合左氧氟沙星,为3CVL2Pa Z/9VL2Pa,比较两组患者治疗12个月后的临床疗效。结果观察组治疗3个月、6个月、9个月、12个月的涂阳阴转率(51.7%、58.3%、80.0%、85.0%)均高于对照组(25.0%、31.7%、43.3%、48.3%)(P<0.05);观察组的治疗有效率高于对照组(81.7%vs.45.0%)(P<0.05);观察组的CD3^+、CD4^+、CD8^+水平均高于对照组(P<0.05),CD4^+/CD8^+组间比较差异无统计学意义(P>0.05);观察组的不良反应总体发生率低于对照组(8.3%vs.25.0%)(P<0.05)。结论对复治涂阳肺结核患者应用卷曲霉素、左氧氟沙星联合治疗具有良好的治疗效果,可明显改善临床症状和体征、促进肺部空洞闭合,改善患者免疫功能,具有较高的临床应用价值。Objective To observe the clinical efficacy of Curleomycin combined with Levofloxacin in the treatment of recombinant smear positive pulmonary tuberculosis. Methods A prospective randomized,double blind control study was performed,120 cases of anti acid bacilli positive pulmonary tuberculosis treated from January 2014 to June 2016 in Qinghai Fourth People＇s Hospital were selected. The patients were randomly divided into two groups according to the random parallel grouping method,with 60 cases in each group. The control group was treated with3 SEL2 Pa Z/9 EL2 Pa,and the observation group was combined with Aspergillus and levofloxacin on the basis of the retreatment scheme,3 CVL2 Pa Z/9 VL2 Pa. The clinical efficacy of the two groups after 12 months of treatment was compared. Results The rate of smear positive and negative conversion（ 51. 7%,58. 3%,80. 0%,85. 0%） in the observation group at 3 months,6 months,9 months and 12 months were higher than those in the control group（ 25. 0%,31. 7%,43. 3%,48. 3%）（ P〈0. 05）. The therapeutic efficiency of the observation group was higher than that of the control group（ 81. 7% vs. 45. 0%）（ P〈0. 05）. The CD3＋,CD4＋and CD8＋levels of the observation group were higher than those of the control group（ P〈0. 05）,and the comparison difference between the CD4＋/CD8＋groups was not statistically significant（ P〈0. 05）. The overall incidence of adverse reactions in the observation group was lower than that in the control group（ 8. 3 % vs 25. 0 %）（ P〈0. 05）. Conclusion Curleomycin combined Levofloxacin in treatment of recurrent smear-positive pulmonary tuberculosis patients has good effect,can significantly improve the clinical symptoms and signs,promote lung empty closed,improve immune function in patients with level.Therefore,it has high clinical value.

关 键 词：复治肺结核 抗酸杆菌阳性 卷曲霉素 左氧氟沙星 疗效 不良反应 

分 类 号：R521[医药卫生—内科学]