【摘要】 目的:研究10种二、三线抗结核药两两联用对结核分枝杆菌标准株H37Rv的体外相互作用,为临床耐多药结核的治疗提供参考。方法:采用微孔板阿尔玛蓝指示剂法测定不同浓度莫西沙星(MFX)、左氧氟沙星(LFX)、克拉霉素(CLR)、对氨基水杨酸(PAS)、阿米卡星(AK)、丙硫异烟胺(PTO)、卷曲霉素(CPM)、氯法齐明(CFZ)、对氨基水杨酸异烟肼(PI)、阿莫西林/克拉维酸(AC)共10种二、三线抗结核药单独及两两联用对H37Rv标准株的最低抑菌浓度(MIC),计算分级抑菌浓度(FIC)比以评价各药间的相互作用。结果:FIC值在0.25～0.5之间的有14种药物组合,属协同作用;FIC值在0.5625～0.75的有18种药物组合,属部分协同作用;FIC值在0.76～1的有1种药物组合,属相加作用;FIC值在1～4的有7种药物组合,属无关作用。结论:二、三线抗结核药并不是都适合两两联用,应根据具体情况制订治疗方案。更多还原

【Abstract】 OBJECTIVE:To study the interactions of two-drug selected from 10 second or third line anti-tuberculosis drugs to the mycobacterium tuberculosis H37Rv in vitro,and to provide reference for the treatment of multidrug-resistance tuberculosis. METHODS:Alamar blue susceptibility test was used to determinate the MICs of 10 drugs used alone and some two-drug use to H37Rv. These 10 drugs included moxifloxacin(MFX) ,levofloxacin(LFX) ,clarithromycin(CLR) ,para-aminosalicylic acid(PAS) ,amikacin(AK) ,protionamide(PTO) ,capreomycin(CPM) ,clofazimine(CFZ) ,pasiniazid(PI) and amoxicillin/clavulanic acid(AC) . The fractional inhibitory concentration(FIC) ratio of these combinations was calculated to evaluate the interactions of those drugs. RESULTS:There were 14 combinations whose FIC ratio between 0.25～0.5 belonging to the synergy;18 combinations whose FIC ratio between 0.562 5～0.75 belonged to partial synergy;one combinations whose FIC ratio between 0.76～1 belonged to additive effect;7 combinations whose FIC ratio between 1～4 belonged to indifference. CONCLUSION:Not all second or third line anti-tuberculosis drugs are suitable for two-drug therapy. We should formulate therapeutic scheme according to the condition.更多还原