利福布汀联合莫西沙星治疗耐多药肺结核的近期疗效观察

目的：评价利福布汀和莫西沙星联合化疗方案对耐多药肺结核（MDR-PTB）的疗效。方法：将41例MDR-PTB患者随机分为两组,治疗组21例,采用以莫西沙星（M）、利福布汀（B）为主,联合力克肺疾（D）、丙硫异烟胺（Th）、阿米卡星（A）、乙胺丁醇（E）治疗;对照组20例,采用以左氧氟沙星（V）、利福喷汀（L）为主,联合D、Th、A、E治疗;疗程均为18个月。结果：治疗组痰菌阴转率为85.7%（18/21）,对照组痰菌阴转率为55.0%（11/20）,治疗组明显高于对照组（P〈0.05）。治疗组和对照组病灶显吸率分别为47.6%（10/21）、25.0%（5/20）,差异无统计学意义（P〉0.05）。治疗组和对照组病灶有效率分别为81.0%（17/21）、50.0%（10/20）,差异有统计学意义（P〈0.05）。治疗组和对照组空洞闭合率分别为38.5%（5/13）、27.3%（3/11）,差异无统计学意义（P〉0.05）,且两组间副作用比较差异无统计学意义（P〉0.05）。结论：利福布汀联合莫西沙星方案治疗耐多药肺结核,具有促进痰菌阴转、病灶吸收和空洞闭合的作用,其安全性和耐受性良好。

Short-term Therapeutic Effect of Rifabutin and Moxifloxacin on Multidrug Resistant Pulmonary Tuberculosis

Objective：To evaluate the therapeutic effect of rifabutin（B）and moxifloxacin（M）on multi-drug resistant pulmonary tuberculosis（MDR-PTB）.Method：41 cases of MDR-PTB were randomly divided into two qroups：21 cases of treatment group and 20 cases of control group.The treatment group were treated with moxifloxacin（M）,rifabutin（B）,associated with pasiniazid（D）,protionamide（Th）,amikacin（A）,ethambutol（E）.The control group were treated with levofloxacin（V）,rifampicin（L）,associated with pasiniazid（D）,protionamide（Th）,amikacin（A）,ethambutol（E）.The treatment course were all 18 months.Result：The sputum smear negative conversion rate was 85.7%（18/21）and 55.0%（11/20） respectively in the treatment group and control group（P〈0.05）.The remarkable effective rate in chest X-ray was 47.6%（10/21）,25%（5/20） respectively in the treatment group and the control group（P〈0.05）.The effective rate in chest X-ray was 81%（17/21）,50%（10/20）respectively in the treatment group and the control group（P〈0.05）.The cavity closure rates was 38.5%（5/13）and 27.3%（3/11）respectively（P〈0.05）.There were no significant differences in side effects between the groups（P〈0.05）.Conclusion：Regimens containing rifabutin and moxifloxacin are very effective in sputum negative conversion rate,lesion absorption and cavity closing for the treatment of multi-drug resistant pulmonary tuberculosis,with good safety and tolerance.