摘要
目的探讨左氧氟沙星替代吡嗪酰胺治疗初治涂阳老年肺结核的效果。方法本研究采用前瞻性研究和回顾性研究相结合的方法。2014年1月~2016年8月于北京市房山区结核病防治所共收集符合本研究纳入标准的初治涂阳老年肺结核患者38例。根据课题实施方案的要求分为治疗组和对照组。其中,治疗组为2015年8月~2016年8月纳入患者13例,应用含左氧氟沙星化疗方案以6HL2ELfx为主进行治疗;对照组为2014年1月~2015年6月房山区疾病预防控制中心结核病防治所登记管理的使用国家统一的标准化疗方案以2HL2EZ/4HL2为主治疗的患者25例。分析比较两组患者的规定疗程完成率、治愈率、痰菌阴转率和不良反应发生率的差异。结果治疗组和对照组均完成疗程并治愈,疗程末痰菌阴转率均为100%,出现高尿酸血症的发生率治疗组低于对照组(P<0.05)、总不良反应的发生率治疗组低于对照组(P>0.05),肝损伤的发生率治疗组低于对照组(P>0.05),白细胞减少的发生率治疗组高于对照组(P>0.05)。结论含左氧氟沙星化疗方案与含吡嗪酰胺化疗方案的治疗比较,初治涂阳老年肺结核达到了同样的治疗效果,对控制高尿酸血症有较为突出表现;治疗中注意对白细胞的监测,增加肾功能异常观察指标如尿素UREA、肌酐CREA等。
Objective To investigate the effect of levofloxacin instead of pyrazinamide in the initial treatment of smear-positive elderly tuberculosis.Methods The combination of prospective and retrospective study was used.A total of 38 newly-treated smear-positive elderly patients with tuberculosis who met the inclusion criteria of this study in the Beijing Fangshan District Tuberculosis Prevention and Treatment Center from January 2014 to August 2016 were collected.According to the requirements of the project implementation plan,they were divided into treatment group and observation group.Among them,13 patients from August 2015 to August 2016 were included in the treatment group,and were treated with levofloxacin-containing chemotherapy with 6HL2ELfx as the main treatment.The 25 patients registered and managed in Fangshan District Center for Disease Control and Prevention from January 2014 to June 2015 were included in the control group and underwent national standard chemotherapy regimen with 2HL2EZ/4HL2 as the main treatment.The differences between the completion rate of prescribed course,cure rate,negative sputum conversion rate and adverse reaction rate of the two groups were analyzed and compared.Results Both the treatment group and the control group completed the course of treatment and were cured.At the end of the course,the negative conversion rate of sputum bacteria was 100%.The incidence of hyperuricemia was lower in the treatment group than that in the control group(P<0.05).The incidence of total adverse reactions was lower in the treatment group than that in the control group(P>0.05).The incidence of liver injury was lower in the treatment group than that in the control group(P>0.05),and the incidence of leukopenia was higher in the treatment group than that in the control group(P>0.05).Conclusion Compared with levofloxacin-containing chemotherapy regimens,the pyrazinamide-containing chemotherapy regimens in the initial treatment of smear-positive elderly pulmonary tuberculosis has achieved the same treatment
作者
周佳宇
黄少平
刘玉茹
许春明
张海红
赵霞
ZHOU Jiayu;HUANG Shaoping;LIU Yuru;XU Chunming;ZHANG Haihong;ZHAO Xia(Department of Tuberculosis,Beijing Fangshan District Center for Disease Control and Prevention,Beijing 102445,China;Department of Publicity,Beijing Fangshan District Center for Disease Control and Prevention,Beijing 102445,China;Department of Nutrition and Food Hygiene,Beijing Fangshan District Center for Disease Control and Prevention,Beijing 102445,China)
出处
《中国现代医生》
2020年第5期21-24,共4页
China Modern Doctor
关键词
肺结核
老年
左氧氟沙星
吡嗪酰胺
治疗效果
不良反应
Tuberculosis
Elderly
Levofloxacin
Pyrazinamide
Treatment effect
Adverse reactions
