联合卷曲霉素方案治疗耐多药肺结核疗效分析

目的：评价联合卷曲霉素化疗方案治疗耐多药肺结核（MDR—PTB）的疗效。方法：将153例MDR—PTB患者随机分为两组，观察组79例，以卷曲霉素为主，联合左氧氟沙星、利福喷汀、对氨基水杨酸钠异烟肼、吡嗪酰胺、乙胺丁醇进行治疗。对照组74例以链霉素为主，联合用药同观察组，疗程均为24个月，观察两组痰菌阴转情况和病灶吸收情况。结果：治疗24个月末，观察组痰菌阴转率（84．8％）明显高于对照组（59．5％）（P〈0．01），观察组病灶明显吸收率（50．6％）高于对照组（32．4％）（P〈0．01），观察组的药物不良反应率（31％）与对照组（35％）比较差异无统计学意义（P〉0．05）。结论：联合卷曲霉素的方案治疗MDR—PTB，痰菌阴转和病变吸收好转情况较优，药物不良反应率低，值得在临床上推广应用。

Effects of combined capreomycin on multi-drug resistant pulmonary tuberculosis

Objective: To evaluate the effects of capreomycin combination therapy on multi-drug resistant pulmonary tuberculosis(MDR-PTB) Methods: 153cases of MDR-PTB were divided into observation group(79cases) and control group(74cases).The observation group was treated mainly by capreomycin combined with levofloxacin,Rifampicin,Sodium aminosalicylate,Isoniazid,Pyrazinamide and ethambutol;the control group was treated mainly by ethambutol combined with the same drugs mentioned above.With a treatment course of 24 months,the sputum negative conversion rate and lesions absorption rate of the both groups were evaluated and compared.Results: At the end of the 24th month,the sputum negative conversion rate and lesions absorption rate of the observation group and control group were 84.8% and 51% VS.59.5% and 32% with significant difference(P<0.01).The adverse drug reaction rates of the two groups were 31% and 35% respectively without significant difference(P>0.05)Conclusion: With high sputum negative conversion rate and lesions absorption rate,capreomycin combination therapy is effective on MDR-PTB and worth wide application.