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结核病与肺部健康杂志 ›› 2019, Vol. 8 ›› Issue (2): 149-152.doi: 10.3969/j.issn.2095-3755.2019.02.016

• 短篇论著 • 上一篇    下一篇

抗结核固定剂量复合制剂联合左氧氟沙星治疗复治涂阳肺结核患者的效果分析

梁爽1,韩东伟2,钟威1,毛宁1,刘毅2,蒋轶文1()   

  1. 1.110005 沈阳,辽宁省疾病预防控制中心结核病预防控制所
    2.辽宁省营口市卫生健康事务中心传染病与地方病预防控制科
  • 收稿日期:2019-04-12 出版日期:2019-06-30 发布日期:2019-07-10

Analysis of effect of FDC chemethorapy combined with levofloxacin in patients with smear positive pulmonary tuberculosis

Shuang LIANG1,Dong-wei HAN2,Wei ZHONG1,Ning MAO1,Yi LIU2,Yi-wen JIANG1()   

  1. 1.Center for Tuberculosis Control and Preventon, Liaoning Center for Disease Control and Prevention, Shenyang 110005, China
  • Received:2019-04-12 Online:2019-06-30 Published:2019-07-10

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摘要：

回顾性分析2014年3月至2015年12月辽宁省营口市疾病预防控制中心结核病预防控制所收治的复治涂阳肺结核患者167例。167例患者中,使用抗结核固定剂量复合制剂(FDC)治疗的患者116例,其中使用FDC联合左氧氟沙星治疗的患者51例(简称“联合治疗组”),排除复治涂阳肺结核转为耐药结核病的2例患者,最终49例患者纳入联合治疗组;将使用FDC的65例患者进行编号,通过数字表法随机抽取49例患者,作为FDC治疗组。FDC治疗组采取FDC治疗(3H-R-Z-E/6H-R-E),联合治疗组采取左氧氟沙星+FDC治疗(H-R-Z-E-Lfx/H-R-Z-E-Lfx/6H-R-E-Lfx)。经过治疗后,联合治疗组服药后2、5、8个月的痰菌阴转率、病灶吸收率、空洞缩小率分别为75.5%(37/49)、81.6%(40/49)、83.7%(41/49)、77.6%(38/49)、73.5%(36/49),均明显高于FDC治疗组的51.0%(25/49)、63.3%(31/49)、65.3%(32/49)、57.1%(28/49)、53.1%(26/49),两组比较差异均有统计学意义(χ2值分别为6.32、4.14、4.35、4.64、4.39;P值分别为0.012、0.042、0.037、0.030、0.036)。联合治疗组不良反应发生率为18.4%(9/49),与FDC治疗组的26.5%(13/49)比较,差异无统计学意义(χ2=1.10,P=0.896)。研究认为,应用FDC联合左氧氟沙星治疗复治涂阳肺结核患者疗效较好,可以在基层推广使用。

关键词: 结核, 肺, 复方合剂, 氧氟沙星, 药物疗法, 联合, 疗效比较研究

Abstract:

A retrospective analysis was conducted in 167 patients with re-treatment smear-positive pulmonary tuberculosis (PTB), who received anti-TB treatment at the Center for Tuberculosis Control and Prevention of Yingkou City Center for Disease Control and Prevention from March 2014 to December 2015. Out of those 167 patients, 116 patients received treatment of fixed-dose combination (FDC) anti-TB drugs; among 116 patients, 51 patients were treated by using levofloxacin combined with FDC (namely “combination treatment group”) while 65 patients were treated by using FDC. Out of 51 patients, 2 patients were confirmed to be drug-resistant PTB and their treatment regiments were changed and then excluded from this study, so finally 49 patients with smear-positive PTB were remaining in the combination treatment group. Another forty-nine patients with smear-positive PTB were randomly selected from 65 patients, who received FDC treatment, by using random number table method and as the “FDC treatment group”. The patients in the FDC treatment group received FDC treatment (3 isoniazid+rifampicin+pyrazinamide+ethambutol/6 isoniazid+rifampicin+ethambutol), while the patients in the combination treatment group received treatment of FDC combined with levofloxacin. In the combination treatment group, the sputum negative conversion rate, lesion absorption rate and cavity reduction rate of the patients at 2 months, 5 months and 8 months of treatment were 75.5% (37/49), 81.6% (40/49), 83.7% (41/49), 77.6% (38/49), 73.5% (36/49) respectively, the rates were much higher than those in the FDC treatment group (51.0% (25/49), 63.3% (31/49), 65.3% (32/49), 57.1% (28/49), 53.1% (26/49)). The difference of those rates between the two groups was statistically significant (χ2 values were 6.32, 4.14, 4.35, 4.64, 4.39; P values were 0.012, 0.042, 0.037, 0.030, 0.036). The incidence of adverse reactions in the combination treatment group was 18.4% (9/49), and it was no significant difference compared with that in the FDC treatment group (26.5% (13/49)) (χ2=1.10, P=0.896). So this study showed that the treatment outcomes obviously improved by using FDC combined with levofloxacin in smear-positive pulmonary tuberculosis patients and it might be valuable to expand this chemotherapy method at the grassroots level.

Key words: Tuberculosis, pulmonary, Drug combinations, Ofloxacin, Drug therapy, combination, Comparative effectiveness research

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