不同疗程左氧氟沙星联合四联抗结核疗法治疗结核性渗出性胸膜炎的临床研究  

Clinical study of levofloxacin combined with quadruple anti-tuberculosis therapy in treatment of tuberculous exudative pleurisy with different treatment courses

作　　者：吴璇 张萌涛 王勃 徐纾 WU Xuan;ZHANG Mengtao;WANG Bo;XU Shu(Department of Tuberculosis Medicine,Xi'an Chest Hospital,Xi'an 710100,China;Department of Medical Services,Medicine,Xi'an Chest Hospital,Xi'an 710100,China;Department of Respiratory,Xi'an Chest Hospital,Xi'an 710100,China)

机构地区：[1]西安市胸科医院结核内科,陕西西安710100 [2]西安市胸科医院医务科,陕西西安710100 [3]西安市胸科医院呼吸科,陕西西安710100

出　　处：《药物评价研究》2020年第12期2477-2480,共4页Drug Evaluation Research

基　　金：陕西省重点研发计划项目(2018SF-222)。

摘　　要：目的探讨不同疗程左氧氟沙星联合四联抗结核疗法治疗结核性渗出性胸膜炎的疗效。方法选择2015年6月—2018年6月西安市胸科医院治疗的结核性渗出性胸膜炎患者260例作为研究对象,根据随机数字表法分为对照组和观察组,每组各130例。所有患者均行左氧氟沙星联合四联抗结核方案治疗,四联抗结核方案中,肌注硫酸链霉素注射液0.75 g,1次/d;口服异烟肼片0.3 g,1次/d;口服利福平片0.45 g,1次/d;口服吡嗪酰胺片1.5 g,1次/d。同时静滴盐酸左氧氟沙星注射液500 mg,静滴时间≥60 min,1次/d。对照组连续治疗4周,观察组连续治疗2周。观察两组患者的临床疗效、临床症状及不良反应发生情况,同时比较两组治疗前后的CD4^(+)CD25^(+)T细胞水平。结果治疗后,两组的治疗总有效率比较无统计学意义。两组的积液消失时间、引流流量、穿刺次数、完全退热时间对比无统计学意义。两组治疗后的CD4^(+)CD25^(+)T细胞比例显著高于治疗前(P<0.05),观察组显著高于对照组(P<0.05)。观察组治疗期间的胃肠道反应、关节痛、血小板减少、白细胞减少等发生率为1.5%,低于对照组的9.2%(P<0.05)。结论相对于长疗程,短疗程左氧氟沙星联合四联抗结核疗法治疗结核性渗出性胸膜炎也具有很好的疗效,能促进缓解患者的临床症状,且能减少不良反应的发生,促进恢复患者的免疫功能。Objective To investigate the efficacy of levofloxacin combined with quadruple anti-tuberculosis therapy for tuberculous exudative pleurisy.Methods 260 patients with tuberculous exudative pleurisy treated in Xi’an Chest Hospital from June 2015 to June 2018 were selected as the study subjects,and were divided into control group and observation group according to the random number table method,with 130 patients in each group.All patients were treated with levofloxacin combined with quadruplex antituberculosis regimen.In the quadruplex anti-tuberculosis regimen,patients were performed intramuscular injection of Streptomycin Sulfate Injection for 0.75 g,once daily,po administered with Isoniazid Tablets 0.3 g,once daily,Rifampicin Tablets for 0.45 g,once daily,and Pyrazinamide Tablets 1.5 g,once daily.At the same time,Levofloxacin Hydrochloride Injection was given for 500 mg,intravenous drip time less than 60 min,once daily.The control group received continuous treatment for 4 weeks,and the observation group received continuous treatment for 2 weeks.The clinical efficacy,clinical symptoms,and adverse reactions of two groups were observed,and the levels of CD4^(+)CD25^(+)T cells before and after treatment were compared.Results After treatment,the total effective rate of two groups was not statistically significant.There was no significant difference in the disappearance time of effusion,drainage flow rate,puncture times and complete antipyretic time between two groups.The proportion of CD4^(+)CD25^(+)T cells in two groups after treatment was significantly higher than that before treatment(P<0.05),and that in the observation group was significantly higher than that in the control group(P<0.05).The incidence of gastrointestinal reaction,joint pain,thrombocytopenia and leucopenia in the observation group was 1.5%,which was lower than 9.2%of the control group(P<0.05).Conclusion Compared with the long course of treatment,the short course of levofloxacin combined with quadruple anti tuberculosis therapy in treatment of tube

关 键 词：左氧氟沙星 四联抗结核疗法 结核性渗出性胸膜炎 CD4^(+)CD25^(+)T细胞 

分 类 号：R978.3[医药卫生—药品]