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目的观察两种不同的化疗方案治疗慢性乙型肝炎合并肺结核患者的疗效及对肝功能的影响,为慢性乙型肝炎合并肺结核患者选择治疗方案提供依据。方法将68例合并慢性乙型肝炎肺结核患者随机分为A、B两组,A组采用标准抗结核治疗方案(2HRZS3(E)/4HR)治疗36例,B组采用含左氧氟沙星方案(2HZE,LVFX/7HE,LVFX)治疗32例。观察两组疗程完成情况、x线胸片病灶显著吸收率、痰菌阴转率、肝功能等情况。结果 A组和B组退组率分别为:38.9%(14/36)、11.9%(5/42)(χ2=4.64,P<0.05);2月末痰菌阴转率和X线胸片病灶显著吸收率分别为63.6%(14/22)、86.7%(26/30)(χ2=0.51,P>0.05);54.5%(12/22)、73.3%(22/30)(χ2=0.42,P>0.05);A组和B组肝损害发生率分别为58.3%(21/36)、15.6%(5/32)(χ2=6.10,P<0.05)。结论 A、B两组方案治疗慢性乙肝合并肺结核患者疗效差异无统计学意义,但B组退组率低、肝功能损害的发生率低,患者易坚持耐受,有较好的安全性。
Objective To observe the curative effect of two different chemotherapy regimens on patients with chronic hepatitis B complicated with pulmonary tuberculosis and their effects on liver function, and to provide the basis for selecting treatment options for patients with chronic hepatitis B and pulmonary tuberculosis. Methods Sixty-eight patients with chronic hepatitis B were randomly divided into A and B groups. A group received 36 cases of standard anti-tuberculosis treatment (2HRZS3 (E) / 4HR), while those of B group received levofloxacin (2HZE, LVFX / 7HE, LVFX) treatment of 32 cases. The completion of treatment of two groups were observed, x-ray lesions significantly absorbed rate, sputum negative conversion rate, liver function and so on. Results The group rejection rates of group A and group B were 38.9% (14/36) and 11.9% (5/42) respectively (χ2 = 4.64, P <0.05) Significant absorption rates were 63.6% (14/22), 86.7% (26/30) (χ2 = 0.51, P> 0.05), 54.5% (12/22), 73.3% P> 0.05). The incidence of liver damage in group A and group B were 58.3% (21/36) and 15.6% (5/32) respectively (χ2 = 6.10, P <0.05). Conclusion There is no significant difference in therapeutic effect between A and B groups in patients with chronic hepatitis B and pulmonary tuberculosis. However, patients in B group have a low rate of withdrawal and low incidence of liver dysfunction. Patients are easy to tolerate and have good safety.