摘要
目的探讨左氧氟沙星联合利福喷丁治疗对复治涂阳肺结核患者临床疗效及不良反应发生的影响。方法前瞻性选取2015年1月至2019年12月期间惠州市第六人民医院收治的复治涂阳肺结核患者96例,按数字双盲法将其分为2组,每组各48例。对照组行常规治疗,研究组在此基础上行左氧氟沙星联合利福喷丁治疗,治疗9个月。比较2组患者临床疗效、痰菌转阴率、疾病复发率、不良反应发生率及免疫功能指标水平。结果研究组患者临床治疗有效率高于对照组(95.83%vs.72.92%),差异有统计学意义(P<0.05);治疗后1、3、6个月时研究组患者痰菌转阴率均高于对照组(58.33%vs.27.08%、77.08%vs.45.83%、97.92%vs.81.25%),疾病复发率低于对照组(2.08%vs.18.75%),差异有统计学意义(P<0.05);研究组患者不良反应发生率低于对照组(4.17%vs.27.08%),差异有统计学意义(P<0.05);2组患者治疗前免疫功能指标水平差异无统计学意义(P>0.05);治疗后9个月,研究组患者CD4^+、CD8^+、IgG、IgA、IgM水平均高于对照组[(0.45±0.07)vs.(0.33±0.03)、(0.29±0.01)vs.(0.20±0.01)、(14.75±2.52)mg/mL vs.(12.21±12.20)mg/mL、(3.83±1.45)mg/mL vs.(3.18±1.20)mg/mL、(1.35±0.65)mg/mL vs.(1.08±0.50)mg/mL],差异有统计学意义(P<0.05)。结论复治涂阳肺结核患者应用左氧氟沙星联合利福喷丁治疗,可有效改善机体免疫功能,提高痰菌转阴率,减少不良反应的发生,增强治疗效果,该模式具有较高临床应用价值。
Objective To investigate the effect of levofloxacin combined with rifapentin treatment on the clinical efficacy and adverse reactions of retreated smear-positive pulmonary tuberculosis patients.Methods From January 2015 to December 2019,96 patients with retreated smear-positive pulmonary tuberculosis admitted to the Sixth People's Hospital of Huizhou City were prospectively selected and divided into 2 groups according to the digital double-blind method,with 48 cases in each group.The control group received conventional treatment,and the study group received levofloxacin combined with rifampin on this basis,9 months of treatment.The clinical efficacy,sputum conversion rate,disease recurrence rate,adverse reaction rate,and immune function indexes level of the two groups of patients were compared.Results The effective rate of clinical treatment in the study group was higher than that in the control group(95.83%vs.72.92%),the difference was statistically significant(P<0.05).The negative rate of sputum bacteria in the study group at 1 month,3 months,and 6 months after treatment was higher than the control group(58.33%vs.27.08%,77.08%vs.45.83%,97.92%vs.81.25%),the difference was statistically significant(P<0.05).The disease recurrence rate was lower than the control group(2.08%vs.18.75%),the difference was statistically significant(P<0.05).The adverse reaction rate of patients in the study group was lower than the control group(4.17%vs.27.08%),the difference was statistically significant(P<0.05).There was no statistically significant difference in the levels of immune function indexes between the two groups of patients before treatment(P>0.05),and after 9 months of treatment,the levels of CD4^+,CD8^+,IgG,IgA,and IgM in the study group were higher than those in the control group[(0.45±0.07)vs.(0.33±0.03),(0.29±0.01)vs.(0.20±0.01),(14.75±2.52)mg/mL vs.(12.21±12.20)mg/mL,(3.83±1.45)mg/mL vs.(3.18±1.20)mg/mL,(1.35±0.65)mg/mL vs.(1.08±0.50)mg/mL],the differences were statistically significant(P<0.05).Conclusion Levofloxacin combined with rifapentin for retreatment of smear-positive pulmonary tuberculosis patients can effectively improve the immune function of the body,increase the rate of negative conversion of sputum bacteria,reduce the occurrence of adverse reactions,and enhance the therapeutic effect.This model has high clinical application value.
作者
马燕
朱文通
陈惠峰
MA Yan;ZHU Wen-tong;CHEN Hui-feng(Department of Infectious Diseases,the Sixth People's Hospital of Huizhou City,Huizhou Guangdong 516211,China)
出处
《临床和实验医学杂志》
2020年第24期2640-2643,共4页
Journal of Clinical and Experimental Medicine
关键词
复治涂阳肺结核
左氧氟沙星
利福喷丁
临床疗效
不良反应
Retreatment smear positive pulmonary tuberculosis
Levofloxacin
Rifapentin
Clinical efficacy
Adverse reactions
