【摘要】 目的评价β-内酰胺酶抑制剂对耐多药肺结核的临床作用。方法将60例复治耐多药肺结核患者随机分为治疗组与对照组(各30例),据痰菌药敏及个体化等原则,均给予强化期2个月/巩固期4个月方案抗痨,治疗组在强化期加用安灭菌口服。观察痰菌、胸部X-ray及药物不良反应等。结果治疗组2个月末痰菌阴转率为21.43%(6/28),优于对照组为6.67%(2/30),P<0.05;而6个月末为42.86%(12/28),与对照组26.67%(8/30)无显著性差异,P>0.05。强化期增加该药未见不良反应叠加。结论β-内酰胺酶抑制剂与抗生素的等摩尔复合剂(安灭菌片)长期应用,安全、低毒,有益于痰菌阴转,但仍需进一步的大样本、足疗程的临床试验证实。更多还原

【Abstract】 Objective To evaluate the clinical effect of Beta-lactamase inhibitor to multiple-drug resistant tuberculosis(MDR-TB).Methods 60 cases of re-treated MDR-TB patients were randomly divided into therapy group and control group,each of 30 cases.Basing on drug sensitivity of phlegmy bacterium and personal differences,two groups were given anti-TB program with 2 months of intensive treatment and 4 months of consolidation treatment.During the intensive treatment phase,the therapy group was given oral Amoxicillin and Clavulanate Potassium Tablets.Change of sputum tubercle bacillus,chest-ray and ADR was observed.Results In the end of 2 months of the intensive treatment,the sputum negative conversion rate of the therapy group was 21.43%(6/28),which was better than that in the control group [6.67%(2/30);P<0.05].In the end of 6 months,the sputum negative conversion rate of the therapy group was 42.86%(12/28),and the rate of the controls was 26.67%(8/30):P>0.05.Comparing with the control group,the therapy group with antibiotic didn’t add the ADR.Conclusion The long-term application of the equimolar combinations of β-lactamase inhibitor and antibiotic(Amoxicillin and Clavulanate Potassium Tablets)is of safety and of low toxicity.It increases sputum negative conversion rate of MDR-TB patients.However,it still needs large samples and long term clinical experiments in further study to confirm the present results.更多还原