摘要
目的探讨盐酸左氧氟沙星与盐酸莫西沙星治疗耐多药肺结核患者的临床价值。方法选取2019年1月至2022年6月菏泽市传染病医院收治的60例耐多药肺结核患者作为研究对象,根据随机数字表法分为对照组与观察组,每组30例。两组均行抗结核治疗,对照组在抗结核治疗基础上采用盐酸左氧氟沙星治疗,观察组在抗结核治疗基础上采用盐酸莫西沙星治疗。比较两组临床疗效、炎症因子指标[白细胞介素-6(IL-6)、白细胞介素-4(IL-4)、肿瘤坏死因子-α(TNF-α)及C反应蛋白(CRP)]、痰菌转阴率、免疫功能指标(CD8^(+)、CD4^(+)水平及CD4^(+)/CD8^(+))及不良反应发生情况。结果观察组治疗总有效率为93.33%,高于对照组的73.33%,差异有统计学意义(P<0.05)。治疗后,两组TNF-α、IL-4、IL-6、CRP水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。治疗后3、6、12个月,观察组痰菌转阴率均高于对照组,差异有统计学意义(P<0.05)。治疗后,两组CD4^(+)/CD8^(+)和CD4^(+)水平均高于治疗前,CD8^(+)水平低于治疗前,且观察组CD4^(+)/CD8^(+)和CD4^(+)水平均高于对照组,CD8^(+)水平低于对照组,差异有统计学意义(P<0.05)。观察组不良反应发生率低于对照组,差异有统计学意义(P<0.05)。结论与盐酸左氧氟沙星相比,盐酸莫西沙星治疗耐多药肺结核疗效显著,不仅能改善患者免疫功能,减轻机体炎症反应,且安全性较高,值得临床推广应用。
Objective To investigate the clinical value of levofloxacin hydrochloride and moxifloxacin hydrochloride in the treatment of multidrug resistant pulmonary tuberculosis.Methods 60 patients with multidrug resistant pulmonary tuberculosis treated in Heze Infectious Disease Hospital from January 2019 to June 2022 were selected as research subjects,and they were divided into the control group and the observation group according to random number table method,with 30 cases in each group.Both groups were treated with antituberculosis therapy,the control group was treated with levofloxacin hydrochloride on the basis of anti-tuber culosis therapy,and the observation group was treated with moxifloxacin hydrochloride on the basis of anti-tuber culosis therapy.The clinical efficacy,inflammatory factors(interleukin-6[IL-6],interleukin-4[IL-4],tumor necrosis factor-α[TNF-α]and C-reactive protein[CRP]),sputum negative conversion rate,immune function indicators(CD8^(+),CD4^(+)level and CD4^(+)/CD8^(+))and the occurrence of adverse reactions were compared between the two groups.Results The total effective rate in the observation group was 93.33%,which was higher than 73.33%in the control group,and the difference was statistically significant(P<0.05).After treatment,the levels of TNF-α,IL-4,IL-6 and CRP of the two groups were lower than before treatment,and the observation group was lower than the control group,and the differences were statistically significant(P<0.05).At 3,6 and 12 months after treatment,the sputum negative conversion rate in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).After treatment,CD4^(+)/CD8^(+)and CD4^(+)levels of the two groups were higher than before treatment,CD8^(+)levels were lower than before treatment,and CD4^(+)/CD8^(+)and CD4^(+)levels in the observation group were higher than those in the control group,and CD8^(+)levels was lower than that in the control group,and the differences were statistically significant(P<0.05).The incidence of adverse reactions in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Compared with levofloxacin hydrochloride,the clinical use of moxifloxacin hydrochloride in the treatment of multidrug resistant pulmonary tuberculosis patients can not only improve the immune function,reduce the inflammatory response of the body,and has a high safety,which was worthy of promotion and application.
作者
王文胜
WANG Wensheng(Second Department of Tuberculosis,Heze Infectious Disease Hospital,Heze,Shandong,274000,China)
出处
《当代医学》
2024年第14期39-42,共4页
Contemporary Medicine
关键词
耐多药肺结核
盐酸左氧氟沙星
盐酸莫西沙星
炎症因子
Multidrug resistant pulmonary tuberculosis
Levofloxacin hydrochloride
Moxifloxacin hydrochloride
Inflammatory factors
