摘要
目的确定莫西沙星在治疗耐多药肺结核中的地位。方法对2003—2005年间在广州市胸科医院诊断的65例至少耐异烟肼和利福平的耐多药肺结核病人随机分组,分别接受含莫西沙星每日0.4 g 或左旋氧氟沙星每日0.6 g 的六联耐多药化疗方案治疗.其他药物有丁胺卡那霉素或链霉素、帕司烟肼、丙硫异烟胺、吡嗪酰胺、克拉霉素和乙胺丁醇,治疗半年后进行疗效评估。结果莫西沙星组35例中治愈27例,治愈率77.1%;左氧氟沙星组30例中19例治愈,治愈率63.3%,两组比较 x^2=1.489;P=0.222。两组治愈病例中痰菌阴转时间莫西沙星组(1.9±0.7)个月;左氧氟沙星组(3.0±1.8)个月,P=0.035,而痰菌对左氧氟沙星敏感、患者依从性好、肺部病变范围局限和应用莫西沙星是具独立影响疗效的四大因素。莫西沙星组有4例6次出现恶心、腹胀腹痛的消化系统不良事件。结论莫西沙星具有良好的体内抗结核分支杆菌活性,副反应小,对耐多药肺结核疗效明显优于左氧氟沙星,有较高的临床应用价值。
Objective To evaluate the effectiveness of Moxifloxaein in treatment of multidrug-resistant(MDR)pulmonary tuberculosis.Methods 65 MDR pulmonary Mycobacterium tuberculosis patients were randomized divided into two groups,separately receiving the regimens of contained Moxifloxacin0.4 qd or Levofloxacin 0.6 qd six drugs treatment accompanying with aminoglycosides,prothionamide,pasiniazid,pyrazinamide,ethambutol and clarithromyein from 2003—2005y in Guangzhou chest hospital.The treatment outcomes were evaluated when study executed one and half year later.Results 35 patients in moxifloxacin group had 27 cases cured,and 30 patients in levofloxacin group had 19 cases cured.The success rates were 77.1% versus 63.3%(P=0.222).The time to sputum culture conversion were (1.9±0.7)months and 3.0±1.8 months(P=0.035).Bacillary susceptible to levofloxacin,good adherence,radi- ographic extent less than one lung,and use of moxifloxacin were independent predictors of favorable outcome(odds ratios,7.3 to 21.4).Conclusion Moxifloxacin was found have a better bactericidal activity in vivo and less side effects. Its efficacy was higher than levofloxacin when incorporated into muhidrug regimens used for treatment of MDR tuberculosis.
出处
《中国实用内科杂志》
CAS
CSCD
北大核心
2006年第S1期133-135,共3页
Chinese Journal of Practical Internal Medicine
关键词
莫西沙星
左氧氟沙星
耐多药
结核肺
Moxifloxacin
Levofloxacin
Muhidrugresistance
Tuberculosis
