"力克菲蒺、利福喷汀、阿米卡星、左氧氟沙星"方案对肝损害肺结核疗效及安全性观察

目的观察“力克肺疾、利福喷汀、阿米卡星、左氧氟沙星”方案对肝功损害肺结核的疗效及安全性。方法对肝功损害肺结核100例采用随机配对分组法分为治疗组(50例)和对照组(50例)。化疗方案:治疗组用力克肺疾(D)、利福喷汀(L)、阿米卡星(K)、左氧氟沙星(V);对照组用异烟肼(H)、利福平(R)、阿米卡星(K)、吡嗪酰胺(Z),疗程均为9个月。结果共有96例患者完成化疗疗程,治疗组49例和对照组47例,治疗9个月后治疗组涂阳阴转率为95.0%,培阳阴转率96.4%;对照组涂阳阴转率为94.4%,培阳阴转率95.7%。疗程结束时治疗组和对照组X线病灶有效率分别为98.0%和97.9%;空洞闭合率分别为61.5%和57.1%;2组在疗效上无显著性差异(P＞0.05);2年复查,治疗组和对照组痰菌复阳率分别为3.7%和4.5%无显著性差异(P＞0.05)。2组肝功能损害治疗组为32.0%,对照组为58.0%,在肝损害上有显著性差异(P＜0.01)。结论“DLKV”方案对肝功能损害肺结核疗效确切且较安全。

Clinical observation on the clinical efficacy and safety of the regimen of ''''Pasiniazid Rifapentine Amikacin and Levofloxcin'''' for lesions of the liver caused by tuberculosis

Objective To observe the clinical efficacy and safety of the treatment regimen of’Pasiniazid, Rifapentine, Amikacin and Levofloxcin’ for lesions of the liver caused by tuberculosis. Methods By random group-matching,100 cases with lesions of the liver caused by tuberculosis were divided into the treatment group(50 cases) and control group(50 cases).The chemotherapy regimen adopted: the treatment group used Pasiniazid(D),Rifapentine(L),Amikacin(K) and Levofloxcin(V) while the control group used Isoniazid(H), Rifampicin(R), Amikacin(K), and Pyrazinamide(Z).The course of treatment was 9 months for both groups. Results Ninty-six cases completed the treatment with 49 cases in the treatment group and 47 cases in the control group.In the treatment group,the sputum negative conversion rate by the end of the 9^th month was 95.0% in smear and 96.4% in culture;while in the control group,the rates were 94.4% and 95.7% respectively.At the end of the treatment,X-rays evidently improved the assimilation of focuses up to 98.0% in the treatment group and 97.9% in the control group;the ratios of cavity closure reached respectively 61.5% and 57.1%;there was no significantdifference in the treatment outcome in the two groups(P＞0.05).The re-checking in 2 years showed that the positive conversion rate was 3.7% in treatment group and 4.5% in control group with no significant different between the two groups.The lesions of the liver was 32.0% in the treatment group and 58.0% in the control group with significant difference in the two groups(P＜0.01). Conclusion The regimen of ’DLKV’ scheme is effective and reliable to cure lesions of the liver caused by tuberculosis and it is easy to expand the application of this regimen in the clinical practice.