莫西沙星在耐多药肺结核治疗中的应用

目的：探讨莫西沙星在耐多药肺结核患者治疗中的应用价值。方法96例耐多药肺结核患者按治疗方法分为两组，观察组48例，在联合治疗中应用莫西沙星；对照组48例，在联合治疗中应用左氧氟沙星，共治疗12个月。治疗后第3、6、12个月进行痰涂片检查，观察不良反应。治疗前后测定血清血管活性肠肽（VIP）水平。结果观察组在治疗后3个月、6个月、12个月的痰菌转阴率分别为36．0％、87．5％、95．8％，对照组分别为62．5％、77．1％、83．3％，观察组痰菌转阴率均明显高于对照组（χ2＝5．12、5．96、7．28，均P＜0.05）。治疗后对照组总有效率为83．3％，观察组总有效率为95．8％，观察组总有效率明显高于对照组（χ2＝5．28，P＜0．05）。两组在治疗后血清VIP分别为（29．3±6．7）ng/L、（20．7±5．4）ng/L，均较治疗前明显降低，与对照组治疗后比较，观察组降低更明显（t＝3．01，P＜0．05）。用药期间，两组白细胞减少、胃肠道反应、肝功能损害及神经系统症状等不良反应发生率差异均无统计学意义（χ2＝1．56、1．74、2．02、0．00，均P＞0．05）。结论莫西沙星治疗耐多药肺结核效果优于左氧氟沙星。

Application of moxifloxacin in patients with multidrug-resistant tuberculosis

Objective To study the effect of moxifloxacin in the treatment of patients with multidrug-resistant tuberculosis .Methods 96 patients with multidrug-resistant tuberculosis were randomly divided into the two groups . The observation group（n=48 cases） was treated by moxifloxacin,and the control group（n=48 cases） was treated by levofloxacin.They were treated for 12 months.3,6,12 months after treatment,sputum smears were taken,and the adverse reactions were observed .Serum vasoactive intestinal peptide （ VIP） level was measured before and after treat-ment.Results 3,6,12 months after treatment,the sputum negative rates in the observation group were 36.0%, 87.5%,95.8%,which were significantly higher than 62.5%,77.1%,83.3% in the control group （χ2 =5.12, 5.96,7.28,all P〈0.05）.The total effective rate of the control group was 83.3%,which was significantly lower than 95.8%of the observation group （χ2 =5.28,P〈0.05）.Serum VIP levels in the control group and observation group were （29.3 ±6.7）ng/L,（20.7 ±5.4）ng/L.After treatment,the serum VIP levels in the two groups were significant-ly decreased,and the serum VIP level of the observation group was lower compared with the control group （t=3.01, P〈0.05）.During treatment,neutropenia,the incidence rates of gastrointestinal side effects ,liver damage and neuro-logical symptoms and other adverse reactions had no significant differences between the two groups （χ2 =1.56,1.74, 2.02,0.00,all P〉0.05）.Conclusion Moxifloxacin is better than levofloxacin in the treatment of patients with multidrug-resistant tuberculosis.