卷曲霉素和丁胺卡那霉素在老年耐药结核治疗中的对比观察

目的观察和评价卷曲霉素和丁胺卡那霉素联合化疗方案在耐多药结核病（MDR—TB）治疗中的疗效和副作用。方法将116例MDR—TB患者均衡分为治疗组58例和对照组58例。化疗方案：治疗组用卷曲霉素联合吡嗪酰胺、乙胺丁醇、左氧氟沙星、对氨基水杨酸钠、丙硫异烟胺，对照组用丁胺卡那霉素，联合用药同治疗组。结果共有97例患者完成化疗疗程，治疗组49例，对照组48例。痰菌阴转率治疗组71．4％;对照组52．1％，治疗组明显高于对照组，两组比较差异显著（P〈0．05）；病灶吸收总有效率治疗组88．8％，对照组64．6％，治疗组优于对照组，两组比较差异显著（P〈0．05）；治疗组耳毒性肾毒性轻微，且易纠正，总药物不良反应率治疗组为10．2％，对照组为14．6％，治疗组低于对照组，两组比较差异显著俨〈0．05）。结论卷曲霉素治疗MDR-TB疗效优于丁胺卡那霉素，副反应小于丁胺卡那霉素，安全有效，’值得临床推广应用。

Comparative Observation of Capreomycin and Amikacin in the Treatment of Aged-Related Multidrug-Resistant Pulmonary Tuberculosis

Objective To observe and evaluate the efficacy and side effects of capreomycin （CPM） and amikacin （AMK） combined with chemotherapy in the treatment of multidrug-resistant pulmonary tuberculosis （MDR- TB）. Methods 116 cases patients with MDR-TB were averagely divided into the treatment and control groups. Each group had 58 cases. Chemotherapy regimens： the treatment group were given the combination of CPM, PZA, ethambutol（EMB）, levofloxacin （LVFX）, sodium aminosalicylate （PAS）, and Protionamide（PTH）, while the control group were given the combination of AMK, PZA, EMB, LVFX, PAS, and PTH. Results 97 patients had completed the chemotherapy treatment, 49 cases were in the treatment group, and 48 cases were in the control group. Sputum negative conversion rate was 71.4% in the treatment group, while the control group was 52.1%, the treatment group was significantly higher than the control group （P 〈 0.05）. The foci absorption total effective rate was 88.8% in the treatment group, while the control group was 64.6%, the treatment group was significantly better than the control group （P〈0.05）. The ototoxicity and renal toxicity was slight in the treatment group, and easy to correct. The total adverse drug reactions was 10.2%, while the control group was 14.6%. The treatment group was significantly lower than the control group, the differences between the two groups were significant （P 〈0.05）. Conclusion CPM was superior to AMK in the treatment of MDR-TB, and side effects was less than AMK, so it is safe and effective, and worthy of clinical application.