关键词: 泛耐药结核病, 利奈唑胺, 多种药物疗法, 疗效比较研究

Abstract:

Objective To explore the clinical efficacy and adverse reactions of linezolid in the treatment of extensively drug-resistant pulmonary tuberculosis (XDR-PTB) patients. Methods Sixty-five XDR-PTB patients enrolled in Dalian Drug-resistant Tuberculosis Project from July 2012 to December 2019 were divided into control group (routine chemotherapy without linezolid, 31 cases) and observation group (linezolid combined with routine chemotherapy, 34 cases) according to their drug history and whether the individualized treatment regimen included linezolid. The therapeutic effect and the occurrence of adverse reactions between the two groups were compared. Results The conversion rate of sputum culture at 6 months, 12 months and the end of treatment in observation group were 47.1% (16/34), 67.6% (23/34) and 61.8% (21/34) respectively, which were significantly higher than those of the control group (16.1% (5/31), 35.5% (11/31) and 32.3% (10/31)). The differences were statistical significance (χ² were 7.093, 6.724 and 5.659, P values were 0.008, 0.010 and 0.017). At the end of treatment, chest radiograph of 73.5% (25/34) patients in the observation group showed improvement of the lesion, which was significantly higher than that of the control group (41.9%, 13/31). The difference was statistically significant (χ²=6.665, P=0.010). The clinical symptoms of 27 patients in the observation group (79.4%, 27/34) were significantly improved, which was significantly higher than that in the control group (51.6%, 16/31) (χ²=5.597, P=0.018). However, in terms of adverse reactions, the incidence of lower limb numbness in the observation group was 29.4% (10/34), and the incidence of anemia was 11.8% (4/34), the control group did not have the above adverse reactions. Conclusion Linezolid has a definite therapeutic effect on XDR-PTB, but there are many adverse reactions exist, so that patients should be closely observed and treated.

Key words: Extensively drug-resistant tuberculosis, Linezolid, Polypharmacy, Comparative effectiveness research