含左氧氟沙星短程方案治疗初治菌阳肺结核的临床效果

doi:10.19983/j.issn.2096-8493.20210145

结核与肺部疾病杂志 ›› 2022, Vol. 3 ›› Issue (1): 19-21.doi: 10.19983/j.issn.2096-8493.20210145

含左氧氟沙星短程方案治疗初治菌阳肺结核的临床效果

陈壮濠(), 林健雄, 曾丽翔

广东省汕头市结核病防治所,汕头 515031

收稿日期:2021-11-22 出版日期:2022-02-20 发布日期:2022-02-24
通信作者: 陈壮濠 E-mail:475746800@qq.com
基金资助:
2017年度汕头市科技计划项目(汕府办〔2017〕166-18)

Clinical effect of short-term regimen containing levofloxacin in the treatment of newly diagnosed bacteria-positive pulmonary tuberculosis

CHEN Zhuang-hao(), LIN Jian-xiong, ZENG Li-xiang

Shantou Tuberculosis Prevention and Treatment Institution, Guangdong Province, Shantou 515031, China

Received:2021-11-22 Online:2022-02-20 Published:2022-02-24
Contact: CHEN Zhuang-hao E-mail:475746800@qq.com
Supported by:
2017 Shantou Science and Technology Plan Project (SFB〔2017〕166-18)

摘要/Abstract

摘要：

目的: 分析含左氧氟沙星(Lfx)短程方案治疗初治菌阳肺结核的临床效果。方法: 采用前瞻性研究方法,于2017年1月至2019年12月连续纳入汕头市结核病防治所收治的132例初治菌阳肺结核患者,进行编号;采用随机数字表法分为观察组(68例)和对照组(64例)。对照组采用常规2H-R-Z-E/4H-R方案(H:异烟肼;R:利福平;Z:吡嗪酰胺;E:乙胺丁醇),观察组采用4.5Lfx-H-R-E-Z方案。比较两组的治愈率、痰菌阴转率、病灶吸收情况、药物不良反应发生率和复发率。结果: 观察组治愈率为100.0%(68/68),明显高于对照组的治愈率[90.6%(58/64)],差异有统计学意义(Fisher精确概率法,P=0.011)。观察组和对照组治疗2个月末(8周)痰菌阴转率分别为97.1%(66/68)和96.9%(62/64),差异无统计学意义(Fisher精确概率法,P>0.05)。观察组病灶吸收总有效率为100.0%(68/68),对照组总有效率为90.6%(58/64),差异无统计学意义(χ²=3.552,P=0.470)。观察组和对照组的药物不良反应发生率分别为20.6%(14/68)和18.8%(12/64),差异无统计学意义(χ²=0.070,P=0.791)。随访2年后,观察组复发率为2.9%(2/68),对照组为3.1%(2/64),差异无统计学意义(Fisher精确概率法,P=1.000)。结论: 含Lfx短程方案治疗初治菌阳肺结核的疗效确切且较安全。

关键词: 结核,肺, 喹诺酮类, 药物疗法, 治疗应用

Abstract:

Objective: To analyze the clinical effect of short-term regimen containing levofloxacin (Lfx) in the treatment of newly diagnosed bacteria-positive pulmonary tuberculosis. Methods: A prospective study was conducted in 132 newly diagnosed bacteria-positive pulmonary tuberculosis patients in Shantou Tuberculosis Prevention and Treatment Institution from January 2017 to December 2019. The patients were consecutively numbered and randomly divided into observation group (n=68) and control group (n=64). The control group was treated with routine 2H-R-Z-E/4H-R scheme (H: isoniazid; R: rifampicin; Z: pyrazinamide; E: ethambutol), and the observation group was treated with 4.5Lfx-H-R-E-Z scheme. The cure rate, sputum negative conversion rate, focus absorption, incidence of adverse drug reactions and recurrence rate were compared between the two groups. Results: The cure rate of the observation group was 100.0% (68/68), which was significantly higher than that of the control group (90.6% (58/64))(Fisher’s exact probability method, P=0.011). The negative conversion rates of sputum bacteria in the observation group and the control group at the end of 2 months (8 weeks) of treatment were 97.1% (66/68) and 96.9% (62/64), respectively, with no significant difference (Fisher’s exact probability method, P>0.05). The total effective rate of lesion absorption was 100.0% (68/68) in the observation group and 90.6% (58/64) in the control group, with no significant difference (χ²=3.552, P=0.470). The incidence of adverse drug reactions in the observation group and the control group were 20.6% (14/68) and 18.8% (12/64), respectively, with no significant difference (χ²=0.070, P=0.791). After 2 years of follow-up, the recurrence rate was 2.9% (2/68) in the observation group and 3.1% (2/64) in the control group, with no significant difference (Fisher’s exact probability method, P=1.000). Conclusion: The short-term regimen containing Lfx is effective and safe in the treatment of newly diagnosed bacteria-positive pulmonary tuberculosis.

Key words: Tuberculosis,pulmonary, Quinolones, Drug therapy, Therapeutic uses

中图分类号:

R521
R978.3

陈壮濠, 林健雄, 曾丽翔. 含左氧氟沙星短程方案治疗初治菌阳肺结核的临床效果[J]. 结核与肺部疾病杂志, 2022, 3(1): 19-21. doi: 10.19983/j.issn.2096-8493.20210145

CHEN Zhuang-hao, LIN Jian-xiong, ZENG Li-xiang. Clinical effect of short-term regimen containing levofloxacin in the treatment of newly diagnosed bacteria-positive pulmonary tuberculosis[J]. Journal of Tuberculosis and Lung Disease, 2022, 3(1): 19-21. doi: 10.19983/j.issn.2096-8493.20210145

图/表 1

参考文献 5

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[4]	Jawahar MS, Banurekha VV, Paramasivan CN, et al. Randomized clinical trial of thrice-weekly 4-month moxifloxacin or gatifloxacin containing regimens in the treatment of new sputum positive pulmonary tuberculosis patients. PLoS One, 2013, 8(7):e67030. doi: 10.1371/journal.pone.0067030. doi: 10.1371/journal.pone.0067030 URL
[5]	Velayutham BV, Allaudeen IS, Sivaramakrishnan GN, et al. Sputum culture conversion with moxifloxacin-containing regimens in the treatment of patients with newly diagnosed sputum-positive pulmonary tuberculosis in South India. Clin Infect Dis, 2014, 59(10):e142-e149. doi: 10.1093/cid/ciu550. doi: 10.1093/cid/ciu550 URL

组别	例数	全吸[例 (构成比,%)]	显吸[例 (构成比,%)]	吸收[例 (构成比,%)]	不变[例 (构成比,%)]	恶化[例 (构成比,%)]	总有效[例 (有效率,%)]
观察组	68	46(67.6)	12(17.6)	10(14.8)	0(0.0)	0(0.0)	68(100.0)
对照组	64	36(56.3)	12(18.8)	10(15.6)	6(9.3)	0(0.0)	58(90.6)

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含左氧氟沙星短程方案治疗初治菌阳肺结核的临床效果

Clinical effect of short-term regimen containing levofloxacin in the treatment of newly diagnosed bacteria-positive pulmonary tuberculosis

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