免疫药物联合利奈唑胺治疗耐药性肺结核的临床疗效  

Clinical efficacy of immunodrugs combined with linezolid in the treatment of drug-resistant pulmonary tuberculosis

作　　者：顾晓峰 蔡春葵 许岩 GU Xiaofeng;CAI Chunkui;XU Yan(Drug-resistant Clinic,Tuberculosis Hospital in Dalian,Dalian,Liaoning,116000,China)

机构地区：[1]大连市结核病医院耐药门诊,辽宁大连116000

出　　处：《当代医学》2024年第1期62-65,共4页Contemporary Medicine

摘　　要：目的探讨免疫药物联合利奈唑胺治疗耐药性肺结核的临床疗效。方法选取2019年7月至2020年12月辽宁大连市结核病医院收治的80例耐药性肺结核患者作为研究对象,按照随机数字表法分为对照组与观察组,各40例。对照组给予常规耐药结核方案治疗,观察组给予免疫药物联合利奈唑胺治疗,比较血清标志物、炎症因子、治疗时间、结核分枝杆菌转阴率、临床疗效、肺叶切除率、不良反应发生情况。结果治疗前,两组总抗氧化态(TAS)、血清总氧化态(TOS)、氧磷酶-1(PON-1)、降钙素原(PCT)、红细胞沉降率(ESR)及C反应蛋白(CRP)水平比较差异无统计学意义;治疗6个月,两组TAS、PON-1水平均高于治疗前,TOS、PCT、ESR、CRP水平均低于治疗前,且观察组TAS、PON-1水平均高于对照组,TOS、PCT、ESR、CRP水平均低于对照组,差异有统计学意义(P<0.05)。观察组强化治疗时间、总治疗时间、痰涂片转阴时间、肺部空洞收缩时间及肺部空洞闭合时间均短于对照组,差异有统计学意义(P<0.05)。治疗1个月后,两组结核分枝杆菌转阴率比较差异无统计学意义;治疗3、6个月后,观察组结核分枝杆菌转阴率均高于对照组,差异有统计学意义(P<0.05)。观察组治疗总有效率为95.00%,高于对照组的80.00%,肺叶切除率为0.00%,低于对照组的10.00%,差异有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义。结论免疫药物联合利奈唑胺治疗耐药性肺结核疗效确切,可快速抑制患者结核分枝杆菌水平,缓解临床症状,降低不良防疫发生风险,缩短治疗时间,值得临床推广应用。Objective To explore the value of immunodrugs combined with linezolid in the treatment of drug-resistant pulmonary tuberculosis.Methods 80 cases of drug-resistant pulmonary tuberculosis admitted to Tuberculosis Hospital in Dalian from July 2019 to December 2020 were se-lected as the study subjects,and they were divided into the control group and the observation group according to the random number table method,with 40 cases in each group.The control group was treated with conventional drug-resistant tuberculosis regimen,and the observation group was treated with immunodrugs combined with linezolid,serum markers,inflammatory factors,the duration of treatment,the rate of tuberculosis,clinical efficacy,lobectomy rate,and the occurrence of adverse reactions were compared between two groups.Results Before treatment,there were no sig-nificant differences in total antioxidant state(TAS),total serum oxidation state(TOS),oxygenase-1(PON-1),procalcitonin(PCT),erythrocyte sedi-mentation rate(ESR)and C-reactive protein(CRP)between two groups;after 6 months of treatment,TAS and PON-1 levels of two groups were higher than before treatment,TOS,PCT,ESR and CRP levels were lower than before treatment,and TAS and PON-1 levels in the observation group were higher than those in the control group,TOS,PCT,ESR and CRP levels were lower than those in the control group,the differences were statisti-cally significant(P<0.05).The duration of intensive treatment,total treatment time,sputum smear conversion,lung cavity contraction and lung cav-ity closure time in the observation group were shorter than those in the control group,the differences were statistically significant(P<0.05).After 1 month of treatment,there was no significant difference in negative conversion rate between the two groups;after 3 and 6 months of treatment,the neg-ative conversion rate of tuberculosis bacteria in the observation group was higher than that in the control group,and the difference was statistically sig-nificant(P<0.05),the difference was statistically sign

关 键 词：免疫药物 利奈唑胺 耐药性肺结核 血清总氧化态 降钙素原 

分 类 号：R521[医药卫生—内科学]