耐多药肺结核病患者应用化疗方案的疗效分析

摘要

目的：探讨应用化疗方案对耐多药肺结核病（MDR-TB）患者的临床疗效与转阴率。方法选取收治的100例MDR-TB患者，随机分成观察组、对照组各50例，对照组给予常规方案治疗，观察组强化期采用左氧氟沙星、丙硫异烟胺、利福喷汀、乙胺丁醇、吡嗪酰胺（5种药物）进行治疗，疗程为3个月，巩固期采用左氧氟沙星、丙硫异烟胺、利福喷汀3种药物进行治疗，疗程为15个月。治疗过程中每月进行痰结核菌检查，并定期复查胸片、肝肾功能等。结果治疗结束，观察组的病灶吸收率、空洞闭合率均显著高于对照组（P＜0．05）；观察组患者3个月、6个月、9个月、12个月、18个月的转阴率均显著高于对照组（P＜0．05）；两组患者在治疗期间出现轻度胃肠道反应、过敏反应、轻度肝肾损伤发生率，但差异无统计学意义（P＞0．05）。所有出现不良反应的患者均自愈，未合用其他药物治疗。结论观察组化疗方案对于 MDR-TB具有显著的临床疗效，且不良反应相对较少。%Objective To discuss the effect of chemotherapy in treatment of multiple drug resistant tuberculosis (MDR-TB)and their negative rate.Methods A total of 100 patients with patients MDR-TB were randomly divided into observation group and control group,50 cases a group.Control group was given conventional treatment and observation group intensive period of levofloxacin,ethionamide,rifapentine,ethambutol,pyrazine amide (5 kinds of drugs)in the treatment for 3 months.Levofloxacin,ethionamide,rifapentine were used as consolidation treatment for 1 5 months.Each month during the treatment,tuberculosis in sputum was detected.Chest X-ray,liver and kidney function were checked regularly.Results At the end of treatment,focus absorbance,cavity closure rate of observation group were significantly higher than those of control group (P <0.05 ).Negative rate of observation group in 3 months,6 months,9 months,1 2 months,1 8 months were significantly higher than that of the control group (P <0.05).Two groups experienced mild gastrointestinal reactions,allergic reaction,mild liver or kidney injury during the treatment,but they had no significant difference(P >0.05).All patients with adverse reactions were cured without drug use.Conclusion Chemotherapy of observation group has significant clinical efficacy for MDR-TB,and has relatively less adverse reactions.