异烟肼+乙胺丁醇+氧氟沙星+吡嗪酰胺+链霉素治疗利福平耐药肺结核的效果研究  

Study on the effect of isoniazid+ethambutol+ofloxacin+pyrazinamide+streptomycin in the treatment of rifampicin-resistant pulmonary tuberculosis

作　　者：海霞 HAI Xia(Liaoyang Chest Hospital,Liaoyang 111005,China)

机构地区：[1]辽宁省辽阳市胸科医院,111005

出　　处：《中国现代药物应用》2022年第19期120-122,共3页Chinese Journal of Modern Drug Application

摘　　要：目的 分析异烟肼+乙胺丁醇+氧氟沙星+吡嗪酰胺+链霉素治疗利福平耐药肺结核患者的效果。方法 104例利福平耐药肺结核患者,应用随机综合平衡法分为实验组与对照组,各52例。对照组采取帕司烟肼+氧氟沙星+吡嗪酰胺+乙胺丁醇进行治疗,实验组采取异烟肼+乙胺丁醇+氧氟沙星+吡嗪酰胺+链霉素进行治疗。比较两组患者治疗前后血清炎症因子[血清β内啡肽(β-EP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、C反应蛋白(CRP)]水平、肺功能指标[第1秒用力呼气容积(FEV1)、每分钟最大通气量(MVV)、呼气峰流速(PEF)]及不良反应发生情况。结果 治疗后,实验组患者的β-EP、CRP、TNF-α、IL-6分别为(72.35±5.42)ng/L、(21.23±9.58)mg/L、(82.43±17.56)ng/L、(70.45±13.56)pg/ml,均低于对照组的(74.69±5.24)ng/L、(25.24±9.45)mg/L、(90.23±17.45)ng/L、(76.53±13.34)pg/ml,差异均有统计学意义(P<0.05)。治疗后,实验组患者的MVV、FEV1、PEF分别为(1.95±0.64)L/s、(2.37±0.68)L、(5.34±2.34)L/s,均高于对照组的(1.49±0.65)L/s、(1.75±0.72)L、(3.99±2.43)L/s,差异具有统计学意义(P<0.05)。实验组患者的不良反应发生率11.54%(6/52)低于对照组的26.92%(14/52),差异具有统计学意义(χ^(2)=3.9619,P=0.0465<0.05)。两组不良反应均未对患者造成严重影响,且停药后不良反应消失。结论 利福平耐药肺结核患者采用异烟肼+乙胺丁醇+氧氟沙星+吡嗪酰胺+链霉素联合进行治疗,可显著降低炎症因子水平,改善患者肺功能,且不良反应较少,是一种理想、安全的联合治疗方案,具有临床应用、推广价值。Objective To analyze the effect of isoniazid+ethambutol+ofloxacin+pyrazinamide+streptomycin in the treatment of rifampicin-resistant pulmonary tuberculosis.Methods A total of 104 patients with rifampicin-resistant pulmonary tuberculosis were divided into experimental group and control group according to random comprehensive balance method,with 52 cases in each group.The control group was treated with pasoniazid+ofloxacin+pyrazinamide+ethambutol,and the experimental group was treated with isoniazid+ethambutol+of loxacin+pyrazinamide+streptomycin.Both groups were compared in terms of serum inflammatory factors[serumβ-endorphin(β-EP),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),C-reactive protein(CRP)],pulmonary function indicators[forced expiratory volume in the 1st second(FEV1),maximal voluntary ventilation(MVV),peak expiratory flow(PEF)]before and after treatment,and occurrence of adverse reactions.Results After treatment,the levels ofβ-EP,CRP,TNF-α,and IL-6 in the experimental group were(72.35±5.42)ng/L,(21.23±9.58)mg/L,(82.43±17.56)ng/L,and(70.45±13.56)pg/ml,which were lower than(74.69±5.24)ng/L,(25.24±9.45)mg/L,(90.23±17.45)ng/L,(76.53±13.34)pg/ml in the control group,and the differences were all statistically significant(P<0.05).After treatment,the MVV,FEV1,and PEF of the experimental group were(1.95±0.64)L/s,(2.37±0.68)L,and(5.34±2.34)L/s,which were higher than(1.49±0.65)L/s,(1.75±0.72)L,and(3.99±2.43)L/s of the control group,and the differences were all statistically significant(P<0.05).The incidence of adverse reactions in the experimental group was 11.54%(6/52),which was lower than 26.92%(14/52)in the control group,and the difference was statistically significant(χ^(2)=3.9619,P=0.0465<0.05).The adverse reactions in both groups did not cause serious impact on the patients,and the adverse reactions disappeared after drug withdrawal.Conclusion The combined treatment of isoniazid+ethambutol+ofloxacin+pyrazinamide+streptomycin in patients with rifampicin-resistant tuberculosis can si

关 键 词：利福平耐药肺结核 联合用药 炎症因子 

分 类 号：R521[医药卫生—内科学]