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西沙利福布汀联合莫西沙星治疗耐多药肺结核近期疗效观察中国

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【摘要】 目的:评价利福布汀和莫西沙星联合化疗方案对耐多药肺结核(MDR-PTB)的疗效。方法:将41例MDR-PTB患者随机分为两组,治疗组21例,采用以莫西沙星(M)、利福布汀(B)为主,联合力克肺疾(D)、丙硫异烟胺(Th)、阿米卡星(A)、乙胺丁醇(E)治疗;对照组20例,采用以左氧氟沙星(V)、利福喷汀(L)为主,联合D、Th、A、E治疗;疗程均为18个月。结果:治疗组痰菌阴转率为85.7%(18/21),对照组痰菌阴转率为55.0%(11/20),治疗组明显高于对照组(P<0.05)。治疗组和对照组病灶显吸率分别为47.6%(10/21)、25.0%(5/20),差异无统计学意义(P>0.05)。治疗组和对照组病灶有效率分别为81.0%(17/21)、50.0%(10/20),差异有统计学意义(P<0.05)。治疗组和对照组空洞闭合率分别为38.5%(5/13)、27.3%(3/11),差异无统计学意义(P>0.05),且两组间副作用比较差异无统计学意义(P>0.05)。结论:利福布汀联合莫西沙星方案治疗耐多药肺结核,具有促进痰菌阴转、病灶吸收和空洞闭合的作用,其安全性和耐受性良好。
【关键词】 肺结核; 药物疗法; 耐多药; 利福布汀; 莫西沙星
Short-term Therapeutic Effect of Rifabutin and Moxifloxacin on Multidrug Resistant Pulmonary Tuberculosis/ZHANG Ling-li,GUO Sheng-li,ZHAI Shou-heng,et al.//Medical Innovation of China,2013,10(26):034-036
【Abstract】 Objective:To evaluate the therapeutic effect of rifabutin(B) and moxifloxacin(M) on multi-drug resistant pulmonary tuberculosis(MDR-PTB).Method:41 cases of MDR-PTB were randomly divided into two qroups:21 cases of treatment group and 20 cases of control group.The treatment group were treated with moxifloxacin(M),rifabutin(B),associated with pasiniazid(D),protionamide(Th),amikacin(A),ethambutol(E).The control group were treated with levofloxacin(V),rifampicin (L),associated with pasiniazid(D),protionamide(Th),amikacin(A),ethambutol(E).The treatment course were all 18 months.Result:The sputum ear negative conversion rate was 85.7%(18/21) and 55.0%(11/20) respectively in the treatment group and control group (P<0.05).The remarkable effective rate in chest X-ray was 47.6%(10/21),25%(5/20)respectively in the treatment group and the control group (P>0.05).The effective rate in chest X-ray was 81%(17/21),50%(10/20)respectively in the treatment group and the control group (P<0.05).The city closure rates was 38.5%(5/13) and 27.3%(3/11) respectively(P>0.05).There were no significant differences in side effects between the groups(P>0.05).Conclusion:Regimens containing rifabutin and moxifloxacin are very effective in sputum negative conversion rate,lesion absorption and city closing for the treatment of multi-drug resistant pulmonary tuberculosis,with good safety and tolerance.
【Key words】 Pulmonary tuberculosis; Chemotherapy; Multidrug resistant; Rifabutin; Moxifloxacin
First-author’s address:The 264 Hosptial of PLA,Taiyuan 030001,China
doi:10.3969/j.issn.1674-4985.201

3.26.016

耐多药结核病(MDR-TB)的产生和流行是当今结核病控制领域中最迫切的课题,其治疗难度大、费用高、治愈率低、病死率高、传染威害大,已成为重大的公共卫生问题和社会问题。为此开发或引进治疗MDR-PTB的新药、探索新的治疗方案始终是临床工作者研究的重要课题。本院采用以利福布汀和莫西沙星为主的化疗方案治疗21例MDR-PTB患者,取得了较好的效果,现报告如下。

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