不同剂量左氧氟沙星治疗利福平耐药肺结核的临床效果

目的　探讨高剂量和低剂量左氧氟沙星治疗利福平耐药肺结核的疗效。方法　选取2019年5月至2020年9月信阳市第五人民医院收治的利福平耐药肺结核患者90例，根据随机数字表法分为高剂量组和低剂量组，各45例。高剂量组男25例、女20例，年龄（42.16±5.05）岁，给予左氧氟沙星0.6 g/d；低剂量组男23例、女22例，年龄（43.27±5.12）岁，给予左氧氟沙星0.4 g/d。比较两组临床疗效、病灶吸收率、治疗后生命质量及不良反应发生情况。计量资料组间比较采用独立样本t检验，计数资料采用χ²检验。结果　高剂量组治疗有效率及病灶吸收率分别为95.56%（43/45）、91.11%（41/45），均高于低剂量组75.56%（34/45）、66.67%（30/45），差异均有统计学意义（χ²=7.283、8.073，均P<0.05）。高剂量组社会功能、物质生活、躯体功能、心理功能评分分别为（81.25±9.46）分、（81.82±9.39）分、（89.05±8.26）分、（88.03±9.96）分，均高于低剂量组（67.34±7.56）分、（64.31±7.42）分、（65.58±7.47）分、（61.81±7.63）分，差异均有统计学意义（均P<0.05）。两组肺结核患者不良反应发生率比较，差异无统计学意义（χ²=0.080，P=0.777）。结论　高剂量左氧氟沙星治疗利福平耐药肺结核的临床效果显著，可明显促进病灶吸收，提高患者生活质量，且无不良反应增加，具有较高安全性，值得临床进一步推广应用。

Clinical effects of different doses of levofloxacin in the treatment of rifampicin-resistant pulmonary tuberculosis

Objective　To investigate the clinical effects of different doses of levofloxacin in the treatment of rifampicin-resistant pulmonary tuberculosis. Methods　A total of 90 patients with rifampicin-resistant pulmonary tuberculosis were selected from Xinyang Fifth People's Hospital from May 2019 to September 2020, and were divided into a high-dose group and a low-dose group according to the random number table method, with 45 cases in each group. In the high-dose group, there were 25 males and 20 females, aged (42.16±5.05) years, and they were given levofloxacin 0.6 g/d; in the low-dose group, there were 23 males and 22 females, aged (43.27±5.12) years, and they were given levofloxacin 0.4 g/d. The clinical efficacies, focal absorption rates, quality of life, incidences of adverse reactions of the two groups were compared. Independent sample t test was used for the measurement data, and χ² test was used for the count data. Results　The effective rate in the high-dose group 95.56% (43/45)] was higher than that in the low-dose group 75.56% (34/45)], with a statistically significant difference (χ²=7.283, P<0.05). The focal absorption rate in the high-dose group 91.11% (41/45)] was significantly higher than that in the low-dose group 66.67% (30/45)], with a statistically significant difference (χ²=8.073, P<0.05). The scores of social function, material life, physical function, and psychological function in the high-dose group were (81.25±9.46) points, (81.82±9.39) points, (89.05±8.26) points, and (88.03±9.96) points, which were significantly higher than those in the low-dose group (67.34±7.56) points, (64.31±7.42) points, (65.58±7.47) points, and (61.81±7.63) points], with statistically significant differences (all P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (χ²=0.080, P=0.777). Conclusion　The clinical effect of high-dose of levofloxacin in the treatment of rifampicin-resistant pulmonary tuberculosis is significant, which can significantly promote the absorption of lesions and improve the patients' quality of life, without increasing adverse reactions, with high safety, worthy of further clinical application.