含左氧氟沙星短程方案治疗初治菌阳肺结核的临床效果  

Clinical effect of short-term regimen containing levofloxacin in the treatment of newly diagnosed bacteria-positive pulmonary tuberculosis

作　　者：陈壮濠 林健雄 曾丽翔 CHEN Zhuang-hao;LIN Jian-xiong;ZENG Li-xiang(Shantou Tuberculosis Prevention and Treatment Institution,Guangdong Province,Shantou 515031,China)

机构地区：[1]广东省汕头市结核病防治所,汕头515031

出　　处：《结核与肺部疾病杂志》2022年第1期19-21,共3页Journal of Tuberculosis and Lung Disease

基　　金：2017年度汕头市科技计划项目(汕府办〔2017〕166-18)。

摘　　要：目的:分析含左氧氟沙星(Lfx)短程方案治疗初治菌阳肺结核的临床效果。方法:采用前瞻性研究方法,于2017年1月至2019年12月连续纳入汕头市结核病防治所收治的132例初治菌阳肺结核患者,进行编号;采用随机数字表法分为观察组(68例)和对照组(64例)。对照组采用常规2H-R-Z-E/4H-R方案(H:异烟肼;R:利福平;Z:吡嗪酰胺;E:乙胺丁醇),观察组采用4.5Lfx-H-R-E-Z方案。比较两组的治愈率、痰菌阴转率、病灶吸收情况、药物不良反应发生率和复发率。结果:观察组治愈率为100.0%(68/68),明显高于对照组的治愈率[90.6%(58/64)],差异有统计学意义(Fisher精确概率法,P=0.011)。观察组和对照组治疗2个月末(8周)痰菌阴转率分别为97.1%(66/68)和96.9%(62/64),差异无统计学意义(Fisher精确概率法,P>0.05)。观察组病灶吸收总有效率为100.0%(68/68),对照组总有效率为90.6%(58/64),差异无统计学意义(χ^(2)=3.552,P=0.470)。观察组和对照组的药物不良反应发生率分别为20.6%(14/68)和18.8%(12/64),差异无统计学意义(χ^(2)=0.070,P=0.791)。随访2年后,观察组复发率为2.9%(2/68),对照组为3.1%(2/64),差异无统计学意义(Fisher精确概率法,P=1.000)。结论:含Lfx短程方案治疗初治菌阳肺结核的疗效确切且较安全。Objective:To analyze the clinical effect of short-term regimen containing levofloxacin(Lfx)in the treatment of newly diagnosed bacteria-positive pulmonary tuberculosis.Methods:A prospective study was conducted in 132 newly diagnosed bacteria-positive pulmonary tuberculosis patients in Shantou Tuberculosis Prevention and Treatment Institution from January 2017 to December 2019.The patients were consecutively numbered and randomly divided into observation group(n=68)and control group(n=64).The control group was treated with routine 2H-R-Z-E/4H-R scheme(H:isoniazid;R:rifampicin;Z:pyrazinamide;E:ethambutol),and the observation group was treated with 4.5Lfx-H-R-E-Z scheme.The cure rate,sputum negative conversion rate,focus absorption,incidence of adverse drug reactions and recurrence rate were compared between the two groups.Results:The cure rate of the observation group was 100.0%(68/68),which was significantly higher than that of the control group(90.6%(58/64))(Fisher’s exact probability method,P=0.011).The negative conversion rates of sputum bacteria in the observation group and the control group at the end of 2 months(8 weeks)of treatment were 97.1%(66/68)and 96.9%(62/64),respectively,with no significant difference(Fisher’s exact probability method,P>0.05).The total effective rate of lesion absorption was 100.0%(68/68)in the observation group and 90.6%(58/64)in the control group,with no significant difference(χ^(2)=3.552,P=0.470).The incidence of adverse drug reactions in the observation group and the control group were 20.6%(14/68)and 18.8%(12/64),respectively,with no significant difference(χ^(2)=0.070,P=0.791).After 2 years of follow-up,the recurrence rate was 2.9%(2/68)in the observation group and 3.1%(2/64)in the control group,with no significant difference(Fisher’s exact probability method,P=1.000).Conclusion:The short-term regimen containing Lfx is effective and safe in the treatment of newly diagnosed bacteria-positive pulmonary tuberculosis.

关 键 词：结核 肺 喹诺酮类 药物疗法 治疗应用 

分 类 号：R521[医药卫生—内科学] R978.3[医药卫生—临床医学]