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目的对比分析吡嗪酰胺和左氧氟沙星治疗肺结核合并糖尿病的临床疗效。方法以入院病例号为编号,根据随机数字表,将169名肺结核合并糖尿病患者随机分成两组,对照组84例,观察组85例。对照组采用吡嗪酰胺治疗,观察组采用左氧氟沙星治疗。检测治疗前后尿素氮(BUN)、肌酐(Scr)、血尿酸(BUA)和血药峰浓度;取患者晨起清洁中断晨尿,检测尿微量白蛋白(m Alb)。进行痰涂片检查,观察痰菌减少情况。结果对照组患者治疗后BUA检测值明显高于治疗前(P<0.01);且治疗后观察组BUA检测值明显低于对照组(P<0.01)。对照组患者治疗后m Alb检测值明显高于治疗前(P<0.05);且治疗后观察组患者m Alb明显低于对照组(P<0.05)。治疗后观察组痰菌转阴率为81.18%,明显高于对照组的57.14%(P<0.05)。治疗后观察组血药峰浓度为(14.03±1.12)μg/m L,明显高于对照组的(9.12±2.34)μg/m L(P<0.05)。结论左氧氟沙星治疗肺结核合并糖尿病疗效显著,且较吡嗪酰胺治疗肾脏损伤小,但在血药峰浓度升高时应密切观察不良反应。
Objective To compare the clinical efficacy of pyrazinamide and levofloxacin in the treatment of pulmonary tuberculosis complicated with diabetes mellitus. Methods Based on the random number table, 169 patients with pulmonary tuberculosis complicated with diabetes were randomly divided into two groups, 84 cases in the control group and 85 cases in the observation group. The control group was treated with pyrazinamide, and the observation group was treated with levofloxacin. Before and after treatment, BUN, creatinine (Scr), blood urea nitrogen (BUA) and peak plasma concentration were measured. The patient was taken to clean morning urine and the m Alb was detected. Sputum smear examination to observe the reduction of sputum bacteria. Results The BUA in the control group was significantly higher than that before treatment (P <0.01), and the BUA in the observation group was significantly lower than that in the control group after treatment (P <0.01). The value of m Alb in the control group was significantly higher than that before treatment (P <0.05). After treatment, the m Alb in the observation group was significantly lower than that in the control group (P <0.05). After treatment, the sputum negative rate in the observation group was 81.18%, which was significantly higher than that in the control group (57.14%, P <0.05). After treatment, the peak plasma concentration in the observation group was (14.03 ± 1.12) μg / m L, which was significantly higher than that in the control group (9.12 ± 2.34 μg / m L, P <0.05). Conclusion Levofloxacin is effective in treating pulmonary tuberculosis with diabetes mellitus. Compared with pyrazinamide treatment, renal injury is less, but adverse reactions should be closely observed when the peak plasma concentration of levofloxacin is increased.