摘要
目的探讨采用左氧氟沙星联合利福喷丁治疗复治涂阳肺结核患者的效果及不良反应发生情况。方法选择2018年1月—2022年12月苏州市第九人民医院收治的复治涂阳肺结核患者96例作为研究对象,随机分为含利福喷丁抗结核方案治疗对照组(n=48)与联合左氧氟沙星治疗观察组(n=48)。比较两组临床疗效及痰菌转阴率,检测治疗前后两组肿瘤坏死因子-α、白介素-6、白介素-18评估炎症反应,并检测免疫球蛋白A、免疫球蛋白G、免疫球蛋白M评估免疫功能,另比较两组不良反应发生率。结果观察组总有效率为93.75%,治疗后1、3、6个月痰菌转阴率分别为54.17%、70.83%、89.58%,均高于对照组的77.08%、31.25%、47.92%、64.58%,差异有统计学意义(χ^(2)=5.352、5.151、5.225、8.491,P<0.05)。治疗后,观察组肿瘤坏死因子-α(91.27±25.86)pg/L、白介素-6(121.73±20.45)pg/L、白介素-18(97.25±12.50)pg/L,均低于对照组,差异有统计学意义(t=4.612、15.133、10.222,P<0.05)。治疗后,观察组免疫球蛋白A(3.85±0.55)g/L、免疫球蛋白G(15.80±2.37)g/L、免疫球蛋白M(1.40±0.13)g/L,均高于对照组,差异有统计学意义(t=4.237、5.238、8.341,P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论对复治涂阳肺结核患者采用左氧氟沙星联合利福喷丁治疗可提高疗效与痰菌转阴率,可减轻炎症反应,改善免疫功能,用药安全性高。
Objective To investigate the effect of Levofloxacin combined with Rifapentine in the treatment of patients with retreated smear positive pulmonary tuberculosis and the occurrence of adverse reactions.Methods A total of 96 patients with retreated smear-positive pulmonary tuberculosis admitted to the Ninth People's Hospital of Suzhou City from January 2018 to December 2022 were selected as the study objects,and were randomly divided into control group(n=48)treated with anti-tuberculosis regimen containing rifampentine and observation group treated with combined Levofloxacin(n=48).The clinical efficacy and negative sputum conversion rate of the two groups were compared,and tumor necrosis factor-α,interleukin-6 and interleukin-18 were detected before and after treatment to evaluate the inflammatory response,and immunoglobulin A,immunoglobulin G and immunoglobulin M were detected to evaluate the immune function,and the adverse reaction rate was compared between the two groups.Results The total effective rate of the observation group was 93.75%,and the sputum negative conversion rates at 1,3 and 6 months after treatment were 54.17%,70.83%and 89.58%,respectively,which were higher than 77.08%,31.25%,47.92%and 64.58%of the control group,the difference was statistically significant(χ^(2)=5.352,5.151,5.225,8.491,P<0.05).After treatment,tumor necrosis factor-α(91.27±25.86)pg/L,interleukin-6(121.73±20.45)pg/L,and interleukin-18(97.25±12.50)pg/L in observation group were lower than those in control group,and the differences were statistically significant(t=4.612,15.133,10.222,P<0.05).After treatment,immunoglobulin A(3.85±0.55)g/L,immunoglobulin G(15.80±2.37)g/L and immunoglobulin M(1.40±0.13)g/L in the observation group were higher than those in the control group,and the differences were statistically significant(t=4.237,5.238,8.341,P<0.05).There was no statistically significant difference in the rate of adverse reactions between the two groups(P>0.05).Conclusion The use of Levofloxacin combined with Rifapentine in the treatment of patients with recurrent smear-positive pulmonary tuberculosis can improve the efficacy and sputum conversion rate,can reduce the inflammatory response,improve the immune function,and the safety of medication is high.
作者
俞净
叶扬
赵刚
宗玲青
YU Jing;YE Yang;ZHAO Gang;ZONG Lingqing(Department of Infection,Suzhou Ninth People's Hospital,Suzhou,Jiangsu Province,215100 China)
出处
《中外医疗》
2023年第25期92-96,共5页
China & Foreign Medical Treatment
关键词
左氧氟沙星
利福喷丁
复治涂阳
肺结核
临床疗效
不良反应
Levofloxacin
Rifapentine
Recurrent smear-positive
Pulmonary tuberculosis
Clinical efficacy
Adverse effects
