口服莫西沙星与静脉用左氧氟沙星治疗慢性阻塞性肺病急性加重期的疗效比较

目的:观察莫西沙星片剂与左氧氟沙星注射液治疗慢性阻塞性肺病急性加重期(AECOPD)的疗效差异。方法:回顾性的分析216例AECOPD患者,114例使用莫西沙星片剂联合头孢他啶针剂(MOX/CEF组)抗感染治疗,102例使用左氧氟沙星注射液联合头孢他啶针剂(LVF/CEF组)抗感染治疗。观察2组患者临床疗效、细菌清除以及不良反应发生情况(ADR)。结果:2组药物治疗AECOPD患者的有效率均在80%以上,临床疗效差异无统计学意义;2组药物均能有效清除AECOPD患者常见的细菌,如肺炎链球菌、流感嗜血杆菌以及肺炎克雷伯菌等,细菌清除率无统计学差异。MOX/CEF组不良反应主要为胃部不适,LVF/CEF组发生静脉炎的几率多,2组均有中枢神经系统不良反应如兴奋、谵妄发生,多见于75岁以上高龄患者。结论:莫西沙星片剂与左氧氟沙星注射液均能作为AECOPD联合抗感染治疗的有效药物。莫西沙星片在不良反应发生率、用药方便度、价格等方面占有一定优势,因而AECOPD联合治疗中,喹诺酮类药物选择莫西沙星片剂较左氧氟沙星注射液为佳。

The efficacy of oral moxifloxacin and intravenous levofloxacin in the treatment of AECOPD

OBJECTIVE To evaluate the efficacy and safety of moxifloxacin tablets and levofloxacin injection in the treatment of acute exacerbations of chronic obstructive pulmonary disease(AECOPD).METHODS A retrospective analysis of 216 cases of patients with AECOPD was conducted,114 cases using moxifloxacin tablets and ceftazidime injection(MOX/CEF group) anti-infective treatment,102 cases of useing ceftazidime injection combined with levofloxacin injection(LVF/CEF group) anti-infective treatment.The patients were observed of clinical efficacy,bacterial clearance and adverse events(ADR).RESULTS The effective rates for the two groups of drug therapy in patients with AECOPD were more than 80%,which were no significant difference;both groups could effectively clear common bacteria such as Streptococcus pneumoniae,Haemophilus influenzae and Klebsiella pneumoniae,the bacterial clearance rates were no significant difference.The common ADR of MOX/CEF group was stomach discomfort;however the LVF/CEF group was phlebitis.In both groups the central nervous system adverse reactions,such as excited delirium,were mostly found in elderly patients over the age of 75.CONCLUSION Moxifloxacin tablets and levofloxacin injection can be used as AECOPD joint anti-infective treatment drugs.Moxifloxacin tablets in the respects of incidence of adverse reactions,medication convenience,and price occupy a certain advantage,thus in the joint treatment of AECOPD,to select quinolones moxifloxacin tablets is better than levofloxacin injection.