含左氧氟沙星方案对复治肺结核的远期效果评价

目的:评价含左氧氟沙星短程化疗方案对复治菌阳肺结核118例的近、远期疗效.方法:选取复治菌阳肺结核患者118例按1:1比例随机分为试验组(n＝60)和对照组(n＝58),试验组采用左氧氟沙星600mg·d-1、异烟肼300mg·d-1、利福平450mg·d-1及乙胺丁醇1 200mg·d-1等药物联合治疗8个月,对照组使用吡嗪酰胺1 500mg·d-1、异烟肼300mg·d-1、利福平450mg·d-1及乙胺丁醇1 200mg·d-1等药物联合治疗8个月.结果:试验组和对照组经2个月治疗后痰菌阴转率分别为78.33%和67.24%;满疗程痰菌阴转率为81.67%和79.31%.胸部X线显示病灶吸收率为95.00%和91.37%,两组分别有52.78%和37.14%的空洞闭合;随访2年间试验组与对照组复发率分别为4.44%和7.32%;两组药物不良反应发生率为14.75%和26.67%.结论:左氧氟沙星治疗复治菌阳肺结核临床疗效肯定,不良反应少,复发率低,是替代吡嗪酰胺治疗复治菌阳肺结核患者的较佳药物.

Assessment of levofloxacin effectiveness on relapsed sputum positive tuberculosis

Objective:To assess the effects of levofloxacin on relapsed sputum positive tuberculosis. Methods: 118 patients with relapsed sputum positive tuberculosis were randomized to receive daily either 2VHRE/6H3R3E3 regimen including levofloxacin (600mg), isoniazid (300mg), rifampicin (450mg),ethylaminobutyl alcohol (1200mg) (treatment group, n=60) or 2ZHRE/6H3R3E3 regimen including pyrazinamide (1500mg), isoniazid (300mg), rifampicin (450mg) and ethylaminobutyl alcohol (1200mg) (control group, n=58) for eight months. Results: Patients treated with levofloxacin experienced 78. 33 percent of sputum negative conversion rates compared to patients with pyrazinamide, which were 67.24 percent, at the end of 2-month therapy, and 81.67 percent versus 79. 31 percent at the end of full course of the therapy. Chest radiography showed that the revolution of pulmonary lesion accounted for 95.00 percent in the treatment group versus 91.37 percent in the control group as well as cavity closure rates of 52. 78 percent versus 37. 14 percent. The analyses of twoyear follow-up showed that 4.44 percent of relapsed sputum positive tuberculosis was associated with levofloxacin treatment and 7. 32 percent with pyrainamide treatment. Adverse events occurred in 14. 75 percent of the treatment group and 26. 67% percent of the control group. Conclusion: Levofloxacin provided a better alternative to pyrazinamide in the treatment of relapsed sputum positive tuberculosis.