【摘要】 选取2012年6月至2014年6月兰州市胸科医院接诊的符合入选标准的耐多药肺结核患者98例,按照随机化的原则分为研究组(48例)和对照组(50例),研究组患者采用含常用剂量卷曲霉素的化疗方案(6Cm-LfxPto-PAS-Z/18Lfx-Pto-PAS-Z)进行治疗;对照组患者采用国产常用剂量阿米卡星的化疗方案(6Am-Lfx-Pto-PASZ/18Lfx-Pto-PAS-Z)进行治疗。观察两组患者在化疗3、6、12、18及24个月的痰抗酸杆菌阴转率、痰结核分枝杆菌培养的阴转率、胸部X线摄影显示的病灶吸收情况、疗效及不良反应情况。评价含卷曲霉素或阿米卡星两种化疗方案在治疗耐多药肺结核患者中的临床疗效。采用SPSS 17.0软件进行数据分析,计量资料采用t检验,计数资料采用x~2检验,以P<0.05为差异有统计学意义。化疗过程中,研究组有3例患者退组,对照组有2例患者退组。研究组患者化疗3、6、12、18及24个月的痰培养阴转率分别为48.89%(22/45)、57.78%(26/45)、64.44%(29/45)、71.11%(32/45)和80.00%(36/45),明显高于对照组[分别为27.08%(13/48)、35.42%(17/48)、41.67%(20/48)、50.00%(24/48)和56.25%(27/48)],两组比较差异有统计学意义(x~2值分别为4.71、4.67、4.83、4.32、6.00;P值分别为0.030、0.031、0.028、0.038、0.014)。化疗3个月及总疗程结束后,胸部X线摄影显示病灶吸收的总有效率为60.00%(27/45)和84.44%(38/45),明显高于对照组的35.42%(17/48)和56.25%(27/48),两组比较差异有统计学意义(x~2值分别为5.63、8.77;P值分别为0.018、0.003)。两组患者化疗后的药物不良反应发生率分别为22.22%(10/45)和29.17%(14/48),差异无统计学意义(x~2=0.59,P=0.444)。故认为含卷曲霉素的化疗方案治疗耐多药结核病患者的效果明显优于含常用剂量的阿米卡星的化疗方案。更多还原

【Abstract】 Ninety-eight multidrug-resistant tuberculosis(MDR-TB) patients were selected hospitalized from June 2012 to June 2014 and were randomly divided into two groups. Patients in research group(n=48) were treated with capreomycin(6Cm-Lfx-Pto-PAS-Z/18Lfx-Pto-PAS-Z), while patients in control group(n= 50) were treated with amikacin(6Am-Lfx-Pto-PAS-Z/18Lfx-Pto-PAS-Z). Acid-fast bacillus negative rate of phlegm, negative rate of Mycobacterium tuberculosis cultivation, lesions absorption in chest X-ray, curative effects and side effects of both groups were observed after 3,6,12,18,24 months treatment. To evaluate the clinical effects between capreomycin and amikacin added in chemotherapy regimen for MDR-TB patients. The data was analyzed by SPSS 17. 0. T-test and x~2-test was used in measurement data count data individually. P<0.05 suggests a statistically significant difference.Three patients of research group and 2 patients of control group were withdrew from the study. For research group,negative rates of Mycobacterium tuberculosis cultivation after 3, 6, 12, 18, 24 month were 48.89%(22/45),57.78%(26/45), 64.44%(29/45), 71.11%(32/45) and 80. 00%(36/45) respectively, which were higher than those of control group(27.08%(13/48), 35.42%(17/48), 41.67%(20/48), 50.00%(24/48) and 56. 25%(27/48)). The comparison was statistically significant(x~2=4. 71, 4. 67, 4. 83, 4. 32 and 6. 00;P=0. 030, 0. 031,0. 028, 0. 038 and 0. 014). After 3 month treatment, lesions absorption in chest X-ray and curative effects were60.00%(27/45) and 84.44%(38/45) in research group and 35.42%(17/48) and 56.25%(27/48) in control group, The comparison was statistically significant(x~2=5. 63,8. 77, P=0. 018,0. 003). The side effect occurrence rate between two groups were 22. 22%(10/45) and 29.17%(14/48), and showed no significant difference(x~2=0. 59, P=0.444). For the treatment of MDR-TB patients,chemotherapy regimens containing capreomycin is significantly better than that containing common dose of amikacin. significantly.更多还原