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目的探讨利福布汀联合莫西沙星治疗多药耐药肺结核(MDR-TB)的安全性和有效性。方法纳入我院2011年1月至2012年12月收治的80例MDR-TB患者,随机分为治疗组和对照组,每组40例,治疗组含莫西沙星和利福布汀,对照组含利福喷丁和左氧氟沙星,同时两组联合使用其他相同的抗结核药物:丙硫异烟胺、吡嗪酰胺、对氨基水杨酸和阿米卡星。比较两组患者痰菌阴转、病灶吸收、空洞闭合及药物不良反应等差异。结果治疗组各个阶段的症状改善均优于对照组,治疗24个月末,治疗组和对照组的痰菌阴转分别是89.5%和63.2%,病灶吸收好转率分别是84.2%和57.9%,空洞闭合率分别是84.2%和52.6%,治疗组均优于对照组,两组对比差异具有统计学意义(P<0.05)。结论利福布汀联合莫西沙星有助于提高MDR-TB患者的痰菌阴转、病灶吸收和空洞闭合,且药物不良反应发生率低,值得临床推广。
Objective To investigate the safety and efficacy of rifabutin combined with moxifloxacin in the treatment of multidrug-resistant pulmonary tuberculosis (MDR-TB). Methods 80 cases of MDR-TB patients admitted to our hospital from January 2011 to December 2012 were randomly divided into treatment group and control group, 40 cases in each group. The treatment group consisted of moxifloxacin and rifabutin. The control group Containing rifapentine and levofloxacin, while the two groups used the same combination of other anti-TB drugs: prothionamide, pyrazinamide, p-aminosalicylic acid and amikacin. The difference of sputum negative conversion, lesion absorption, void closure and adverse drug reaction between the two groups were compared. Results The symptom improvement in all stages of the treatment group was better than that of the control group. At the end of 24 months of treatment, the sputum negative conversion rates in the treatment group and the control group were 89.5% and 63.2%, respectively, and the recovery rates of the lesions were 84.2% and 57.9% The closure rates were 84.2% and 52.6% respectively. The treatment group was superior to the control group, and the difference between the two groups was statistically significant (P <0.05). Conclusion The combination of rifabutin and moxifloxacin can improve the sputum negative conversion, lesion absorption and cavity closure in patients with MDR-TB, and the low incidence of adverse drug reactions is worthy of clinical promotion.