贝达喹啉联合2HPZE/4HP抗结核方案对老年HBsAg阳性耐多药肺结核的临床疗效分析  

Clinical Efficacy Analysis of Bedaquiline Combined with 2HPZE/4HP Anti-tuberculosis Regimen in Elderly Patients with HBsAg Positive Multidrug-resistant Pulmonary Tuberculosis

作　　者：郭达成 曾香萍 谢高玉 GUO Dacheng;ZENG Xiangping;XIE Gaoyu(Ganzhou Fifth People's Hospital,Ganzhou Jiangxi 341000,China;Xingguo County People's Hospital,Xingguo Jiangxi 342400,China)

机构地区：[1]赣州市第五人民医院,江西赣州341000 [2]兴国县人民医院,江西兴国342400

出　　处：《药品评价》2024年第10期1237-1240,共4页Drug Evaluation

摘　　要：目的分析贝达喹啉联合2HPZE/4HP抗结核方案对老年HBsAg阳性耐多药肺结核的临床疗效。方法2022年1月至2024年1月于赣州市第五人民医院诊治的HBsAg阳性耐多药肺结核老年患者80例,随机分为对照组与试验组,各40例。对照组采用2HPZE/4HP抗结核方案治疗,试验组在此基础上联合贝达喹啉治疗。观察两组临床疗效、免疫功能指标、血清巨噬细胞移动抑制因子(MIF)、骨桥蛋白(OPN)、肝功能指标及不良反应等。结果治疗6个月后,试验组治疗疗效高于对照组(P<0.05);试验组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)高于对照组(P<0.05);两组丙天冬氨酸转氨酶(AST)、氨酸转氨酶(ALT)、直接胆红素(TBIL)水平均升高,但两组差异无统计学意义(P>0.05);试验组CD8^(+)、MIF和OPN低于对照组(P<0.05)。不良反应发生率两组差异无统计学意义(P>0.05)。结论贝达喹啉联合2HPZE/4HP抗结核方案治疗老年HBsAg阳性耐多药肺结核疗效良好,不仅能够调节患者免疫功能,改善血清MIF和OPN水平,且不会增加肝功能损伤风险,耐受性良好。Objective To analyze the clinical efficacy of the combination of bedaquiline and 2HPZE/4HP anti-tuberculosis regimen in elderly patients with HBsAg positive multidrug-resistant pulmonary tuberculosis.Methods A total of 80 elderly patients with HBsAg positive multidrug-resistant pulmonary tuberculosis diagnosed and treated in Ganzhou Fifth People's Hospital from January 2022 to January 2024 were prospectively selected and randomly divided into control group and experimental group,with 40 cases in each group.The control group was treated with 2HPZE/4HP anti-tuberculosis regimen,and the experimental group was treated with bedaquiline on this basis.The clinical efficacy,immune function indexes,serum macrophage migration inhibitory factor(MIF),osteopontin(OPN),liver function indexes and adverse reactions of the two groups were observed.Results After 6 months of treatment,the clinical efficacy of the experimental group was higher than that of the control group(P<0.05);the levels of CD3^(+),CD4^(+),and CD4^(+)/CD8^(+)in the experimental group were higher than those in the control group(P<0.05);the levels of aspartate aminotransferase(AST),alanine aminotransferase(ALT),and direct bilirubin(TBIL)increased in both groups,but there was no statistical difference between the two groups(P>0.05);the levels of CD8^(+),MIF and OPN in the experimental group were lower than those in the control group(P<0.05);and the incidence of adverse reactions was not statistically different between the two groups(P>0.05).Conclusion Bedaquiline combined with 2HPZE/4HP anti-tuberculosis regimen has good efficacy in the treatment of HBsAg positive multidrug resistant pulmonary tuberculosis in elderly patients,can regulate the immune function of patients,improve serum MIF and OPN levels,and does not increase the risk of liver function injury,and is well tolerated.

关 键 词：耐多药肺结核 HBSAG阳性 贝达喹啉 2HPZE/4HP抗结核 免疫功能 巨噬细胞移动抑制因子 骨桥蛋白 

分 类 号：R73[医药卫生—肿瘤]