司帕沙星治疗耐多药肺结核疗效临床研究

[目的]评价含司帕沙星(SPLX)化疗方案对耐多药结核病(MDR-TB)的临床应用价值。[方法]将64例MDR-TB患者随机分为两组各32例,治疗组用司帕沙星0.2 g每晚口服;对照组氧氟沙星(OFLX)0.2 g,3次/d。化疗方案:治疗组3 SPL2ZPTh(E)/9 SPL2Th;对照组3 OL2ZPTh(E)/9 OL2Th。比较治疗3个月、12个月的痰菌阴转率、X线胸片变化、药物不良反应及39例随访2年的复发率。[结果]治疗组3个月痰菌阴转率(75.0%)高于对照组(46.8%,P<0.05);两组满疗程阴转率(90.3%、70.0%)、满疗程X线病灶吸收率(90.3%、60.0%)和空洞闭合率(85.7%、51.8%)差异均显著(P<0.05);39例随访2年复发率分别0%和21.1%(P<0.05)。两组皆无严重不良反应。[结论]SPLX对MDR-TB近期临床疗效显著,具有剂量小、疗程短、2年复发率低的优势。

Clinical Study on the Curative Effect of Sparfloxacin for Multi-drug-resistant Tuberculosis Treatment

To study the clinical curative effect of Sparfloxacin(SPLX) for the treatment of multi-drug-resistant pulmonary tuberculosis(MDR-TB). 64 MDR-TB cases were divided into 2 groups.32 cases were cured with SPLX 0.2/qn(Case-group) and 32 cases were cured with ofloxacin 0.2/tid and other anti-TB drugs(TH.Z.PAS.etc,Control-group).The therapy plans were 3 SpL_(2)ZPTh(E)/9 S_(P)L_(2)Th for Case-group and 3 OL_(2)ZPTh(E)/9 OL_(2)Th for Control-group respectively.The rates of sputum negative conversion,X-ray changing and drug side effect were compared in 3rd month and 12th month,and recurrence rate was observed for 2 years(n=39). The sputum negative conversion rates in Case-group was higher than that in Control group(75.0% and 46.9%) in 3rd mouth;Sputum negative conversion rate,focal absorption rate and closure rate of cavities in 12th mouth(90.3%,90.3% and 85.7%) were higher than those(70.0%,60.0% and 51.8%,P<0.05).The recurrence rate in Case-group(0%) was lower than that in Control-group(21.1%,P<0.05) and no severe adverse reactions in 2 groups. There are significant clinical curative effects to cure MDR-TB by SPLX with low dosage,short course of treatment and low recurrence rate.