【摘要】 目的 研究莫西沙星与左氧氟沙星对耐药性肺结核患者的疗效及痰菌定植的影响。方法 选择2012年6月~2014年5月经痰结核分枝杆菌药物敏感试验确定为耐药性肺结核的住院患者92例实施研究,根据数字法随机分成观察组(应用莫西沙星治疗)及对照组(应用左氧氟沙星治疗)各46例,治疗12个月后对比两组治疗后的整体疗效,在治疗不同时期(1,3,6及12个月)收集患者痰标本进行涂片抗酸染色获得痰菌定植转阴率,观察治疗后的病灶及空洞变化,以及两组药物不良反应。结果 治疗满12个月观察组痰涂片阴性44例,阳性2例,阴转率95.65%,对照组痰涂片阴性38例,阳性8例,阴转率82.61%;观察组治疗1个月~12个月的痰菌定植转阴率均分别显著高于对照组,差异均有统计学意义(x~2=4.449,4.423,6.571,4.039;均P<0.05);观察组的显效率是58.70%,总有效率是97.83%,均显著高于对照组的36.96%及80.43%,差异有统计学意义(x~2=4.356,7.180;均P<0.05)。两组治疗后的病灶及空洞变化对比,差异无统计学意义(x~2=0.337,0.211,0.746,0.123;均P>0.05)。观察组的总不良反应发生率为26.09%,与对照组的32.61%相比,差异无统计学意义(x~2=0.472;P>0.05)。结论 莫西沙星治疗耐药性肺结核患者具有较好的疗效,且能有效改善痰菌定植的状况,安全性较高,值得推荐。更多还原

【Abstract】 Objective To analyze effect of levofloxacin and moxifloxacin in the treatment of drug resistant pulmonary tuberculosis patients and its influence for sputum bacterial colonization.Methods Chose 92 cases accepted treatment of drug-resistant pulmonary tuberculosis as research in the hospital from June 2012 to May 2014.According to the digital method,the were randomly divided into observation group(treated with moxifloxacin) and control group(treated with levofloxacin),46 cases in each,12 months after treatment,compared the overall effect of the treatment between two groups,and at different times(1,3,6 and 12 months),collected patients’ sputum specimens for acid fast staining staining to obtain sputum bacterial clearance rate.Observed the changes in the lesions and cavity and the drugs adverse reactions of the two groups.Results Treatment of 12 months,sputum smear negative of the observation group was 44 cases,positive was 2 cases,and the sputum negative conversion rates was 95.65%.Sputum smear negative of the observation group was 38 cases,positive was 8 cases,the sputum negative conversion rates was 82.61%.The effective rate of the observation group was 58.70%,the total effective rate was 97.83%,which was significantly higher than that of the control group’s 36.96%and 80.43%,and the difference was statistically significant(x~2 = 4.356,7.180;all P<0.05).Observation group treatment for 1 month to 12 months sputum bacteria colonization negative rate were markedly higher than those in control group,the differences were statistically significant(x~2 =4.449,4.423,6.571,4.039;all P<0.05).There was no significant difference between the two groups(x~2= 0.337,0.211,0.746,0.123;all P>0.05).The total adverse reaction rate of the observation group was 26.09%,and the difference was not statistically significant(x~2 = 0.472,P>0.05).Conclusion Moxifloxacin in the treatment of drug-resistant pulmonary tuberculosis patients has good curative effect and can effectively improve the sputum bacteria colonization,has high security,worthy of recommendation.更多还原