含左旋氧氟沙星方案治疗耐多药肺结核疗效分析

目的　观察和评价含左氧氟沙星方案在耐多药肺结核 (MDR TB)治疗中的效果。方法　将 131例复治涂阳耐多药肺结核 (MDR TB)患者随机分为治疗组 6 6例和对照组 6 5例 ;治疗组化疗方案以左旋氧氟沙星为主 ,联合利福喷汀、帕司烟肼、丙硫异烟胺、吡嗪酰胺、阿米卡星 ;对照组用氧氟沙星 ,联合用药同治疗组 ;所有病例疗程均为 2 1个月。结果　共有 12 8例患者完成疗程 ,治疗组 6 4例 ,痰菌阴转率 81.3% ;对照组 6 4例 ,痰菌阴转率 4 6 .9% ,痰菌阴转率治疗组明显高于对照组 (P <0 .0 1) ;治疗组病灶显吸率 4 8.4 % ,空洞闭合率 6 3.0 % ,治疗组明显高于对照组 (P <0 .0 1)。结论　用含左氧氟沙星方案治疗涂阳耐多药肺结核 ,有助于痰菌阴转、病灶吸收和空洞闭合 ,值得推广应用

Clinical efficacy of a combination regimen with levofloxacin in treatment of multi-drug resistant pulmonary tuberculosis

Objective To study the clinical efficacy of a combination therapy with levofloxacin and other second-drug anti-tuberculosis drug in the treatment of multi-drug resistant pulmonary tuberculosis(MDR-TB).Methods One hundred and thirty-one patients with MDR-TB were assigned to a study group(66 cases),treated with levofloxacin,rifapentine,dipasic,protionamide,pyrazinamide and amikacin;or a control group,treated with ofloxacin rifapentine,dipasic,protionamide,pyrazinamide and amikacin.The course of treatment was 21 months.Results Sixty-four csses in the study group and 64 cases in the control goup completed the treatment.The sputum-negative conversion rate in the study group( 81.3%) was significantly higher than that in the control goup( 46.9%)(P< 0.01).The radiographic improvement rate was 48.4% in the study group,significantly higher than that in the control group( 17.2%)(P< 0.01).The closure rate of the lung cavities in the study group( 63.0%) was higher than that in the control group( 20.0%)(P< 0.01).Conclusion The regimen including levofloxacin and other second anti-tuberculosis drugs was effective and safe for the patients with MDR-TB.