吡嗪酰胺联合左氧氟沙星治疗耐多药肺结核的临床疗效分析  

Clinical Efficacy Analysis of Pyrazinamide Combined with Levofloxacin in the Treatment of Multi-drug Resistant Tuberculosis

作　　者：张力公[1] 张冬杰[1] 史珂[1] 张会强 ZHANG Li-gong;ZHANG Dong-jie;SHI Ke;ZHANG Hui-qiang(WardⅢ,Department of Tuberculosis,The First Affiliated Hospital of Xinxiang Medical College,Xinxiang 453100,China)

机构地区：[1]新乡医学院第一附属医院结核内科三病区,新乡453100

出　　处：《中国合理用药探索》2024年第7期62-67,共6页Chinese Journal of Rational Drug Use

基　　金：2021年度河南省医学科技攻关计划联合项目(LHGJ20210526)。

摘　　要：目的:探讨吡嗪酰胺联合左氧氟沙星对耐多药肺结核(MDR-TB)的治疗效果。方法:选取2019年6月~2022年12月某院收治的104例MDR-TB患者作为研究对象,采用随机数字表法分为对照组和观察组,每组52例。对照组在常规抗结核治疗基础上给予左氧氟沙星治疗,观察组在对照组基础上加用吡嗪酰胺。比较两组患者临床治疗总有效率、痰菌阴转率、空洞闭合率、氧化应激指标、炎症因子及不良反应。结果:治疗后,观察组临床治疗总有效率高于对照组(P<0.05);观察组痰菌阴转率、空洞闭合率高于对照组(P<0.05);观察组总抗氧化态(TAS)水平高于对照组,总氧化态(TOS)水平低于对照组(P<0.05);观察组单核细胞趋化蛋白-1(MCP-1)、降钙素原(PCT)、C反应蛋白(CRP)水平低于对照组(P<0.05)。两组食欲不振、肝功能异常等不良反应总发生率比较无统计学差异(P>0.05)。结论:吡嗪酰胺联合左氧氟沙星治疗MDR-TB,可有效改善患者肺部炎症损伤,提高结核分枝杆菌清除率,临床疗效明显,且不增加不良反应的发生风险。Objective:To explore the effect of pyrazinamide combined with levofloxacin in the treatment of multi-drug resistant tuberculosis(MDR-TB).Methods:A total of 104 patients with MDR-TB treated in a hospital from June 2019 to December 2022 were selected and assigned to the control group and observation group by random number table,with 52 patients in each group.Patients in the control group received levofloxacin in addition to conventional anti-tuberculosis treatment,while those in the observation group received pyrazinamide on top of the treatment given in the control group.The total response rate,sputum negative conversion rate,cavity closure rate,oxidative stress index,inflammatory factors and adverse reactions were compared between the two groups.Results:After treatment,the total response rate in the observation group was higher than that of the control group(P<0.05);the sputum negative conversion rate and cavity closure rate in the observation group were higher than those in the control group(P<0.05);the total antioxidant status(TAS)level in the observation group was higher than that in the control group,while the total oxidant status(TOS)level was lower than that in the control group(P<0.05);the levels of monocyte chemoattractant protein-1(MCP-1),procalcitonin(PCT)and C-reactive protein(CRP)in the observation group were lower than those in the control group(P<0.05).No statistically significant difference in the total incidence of adverse reactions including inappetence and hepatic function abnormal was observed between the two groups(P>0.05).Conclusion:Pyrazinamide combined with levofloxacin in the treatment of MDR-TB can effectively improve the pulmonary inflammatory injury and increase the clearance rate of Mycobacterium tuberculosis,with obvious clinical efficacy and without additional risks of adverse reactions.

关 键 词：耐多药肺结核 吡嗪酰胺 左氧氟沙星 临床疗效 不良反应 

分 类 号：R521[医药卫生—内科学]