摘要
目的评价卷曲霉素联合对氨基水杨酸异烟肼在耐多药肺结核(MDR-TB)治疗中的疗效。方法将139例MDR-TB患者随机分为治疗组70例和对照组69例。化疗方案治疗组以卷曲霉素联合对氨基水杨酸异烟肼、吡嗪酰胺、丙硫异烟胺、喹诺酮类药物;对照组以链霉素联合利福喷丁、吡嗪酰胺、丙硫异烟胺、喹诺酮类药,疗程均为21个月,观察两组治疗前后的痰菌阴转、空洞闭合、X光变化及不良反应等。结果完成化疗疗程132例,治疗组64例,痰阴转率87.1%。对照组68例,痰阴转率58%,治疗组明显高于对照组(P<0.01);治疗组病灶显效率48.6%,空洞闭合率83.8%,优于对照组显效率31.9%,空洞闭合率65.7%(P<0.01);治疗组药物不良反应率为57.1%,对照组为53.6%,两组比较差异无显著性(P<0.05)。结论含卷曲霉素联合对氨基水杨酸异烟肼的化疗方案治疗MDR-TB,痰菌阴转和病变吸收好转较优,药物不良反应低,可以在临床推广应用。
Objective To evaluate the joint clinical efficacy of using capreomycin and pasiniaside in treating multi-drug resistant tuberculosis （MDR-TB） patients. Methods 139 cases of MDR-TB patients were randomized into the treatment group （ n = 70） and con- trol group （ n = 69 ）. For the treatment group, the chemotherapy included capreomycin on pasiniaside, pyrazinamide, C sulfur Isonicotinic amines, quinolones; For the control group, the chemotherapy included rifapentine together with streptomycin, pyrasinamide, C sulfur isonicotinic amines, and quinolone. The duration of the treatment for the both groups was 21 months. Observations of the two groups before and after treatment were made on sputum conversion, cavity closure, X-ray changes and adverse reactions. Results A total of 132 patients completed chemotherapy course of treatment. The sputum conversion rates for the treatment and control groups were respectively 87.1% （ n = 64 ） and 58.0% ： P 〈 0. 01. The former group also had better efficacy rates than the latter group in terms of improvement of lesion absorption （48.6% and 31.9 % respectively; P 〈 0.05 ） and in cavity closure （83.8 % and 65.7 % respectively; P 〈 0.05 ）. There was no group difference in adverse drug reaction rate （57. 1% and 53.6% ; P 〉 0.05 ）. Conclusion Combined chemotherapy using capreomycin and pasiniaside has good treatment effects in terms of sputum conversion rate, of improvement of lesion absorption and low adverse drug reactions. It is worth being recommended for a wider use in clinical practice.
出处
《临床肺科杂志》
2007年第8期795-796,共2页
Journal of Clinical Pulmonary Medicine
