[1]莫东军,卓 玛,马英莲,等.两种抗生素治疗方案对耐多药肺结核患者的疗效[J].郑州大学学报(医学版),2019,(06):913-916.[doi:10.13705/j.issn.1671-6825.2018.08.107]
 MO Dongjun,ZHUO Ma,MA Yinglian,et al.Efficacy of two antibiotic regimens on patients with multi-drug resistant tuberculosis[J].JOURNAL OF ZHENGZHOU UNIVERSITY(MEDICAL SCIENCES),2019,(06):913-916.[doi:10.13705/j.issn.1671-6825.2018.08.107]
点击复制

两种抗生素治疗方案对耐多药肺结核患者的疗效()
分享到:

《郑州大学学报(医学版)》[ISSN:1671-6825/CN:41-1340/R]

卷:
期数:
2019年06期
页码:
913-916
栏目:
应用研究
出版日期:
2019-11-20

文章信息/Info

Title:
Efficacy of two antibiotic regimens on patients with multi-drug resistant tuberculosis
作者:
莫东军卓 玛马英莲刘 明王 蓉
青海省第四人民医院呼吸三科 西宁 810000
Author(s):
MO Dongjun ZHUO Ma MA Yinglian LIU Ming WANG Rong
Department of Respiratory Medicine, Qinghai Fourth People's Hospital, Xining 810000
关键词:
抗生素治疗方案 耐多药肺结核 痰菌阴转 空洞变化 不良反应
Keywords:
antibiotic regimen multi-drug resistant tuberculosis sputum negative conversion cavitation adverse reaction
分类号:
R361
DOI:
10.13705/j.issn.1671-6825.2018.08.107
摘要:
目的:对比分析两种抗生素治疗方案对耐多药肺结核(MDR-TB)患者的疗效。方法:MDR-TB患者1 500例进行规范化抗结核治疗,并按抗生素治疗方案的不同分为莫西沙星组(n=872)和左氧氟沙星组(n=628),对比两组疗效及痰菌阴转情况、空洞变化及不良反应发生率。结果:莫西沙星组总有效率为87.73%,高于左氧氟沙星组的81.21%(P<0.001); 治疗3、6、9、12个月时莫西沙星组痰菌阴转率均高于左氧氟沙星组(P<0.05); 治疗12个月后,莫西沙星组空洞闭合、缩小患者比例高于左氧氟沙星组(P<0.05); 莫西沙星组总不良反应发生率低于左氧氟沙星组(P<0.001)。结论:氟奎诺酮类药物辅助治疗MDR-TB时,应用莫西沙星或可取得更佳抗结核获益。
Abstract:
Aim:To analyze the efficacy of two antibiotic regimens on patients with multi-drug resistant tuberculosis(MDR-TB).Methods:A total of 1 500 patients with MDR-TB were allocated into moxifloxacin group(n=872)and levofloxacin group(n=628)according to antibiotic regimens. The curative effects, situation of sputum negative conversion, incidence of cavitation and adverse reactions were compared between the two groups.Results:The total effective rate of moxifloxacin group(87.73%)was significantly higher than that of levofloxacin group(81.21%)(P<0.001). The sputum negative conversion rates in moxifloxacin group after 3,6,9 and 12 months were significantly higher than those in levofloxacin group(P<0.05).The proportions of cavity closure and reduction in moxifloxacin group were significantly higher than those in levofloxacin group(P<0.05). The incidence of adverse reactions in moxifloxacin group was significantly lower than that in levofloxacin group(P<0.001).Conclusion:The efficacy of moxifloxacin is better than levofloxacin in the treatment of MDR-TB.

参考文献/References:

[1] KENDALL EA,FOFANA MO,DOWDY DW.Burden of transmitted multidrug resistance in epidemics of tuberculosis: a transmission modelling analysis[J].Lancet Respir Med,2015,3(12):963
[2] JAGIELSKI T,BAKULA Z,ROESKE K,et al.Detection of mutations associated with isoniazid resistance in multidrug-resistant Mycobacterium tuberculosis clinical isolates[J].J Antimicrob Chemother,2014,69(9):2369
[3] DALAL A,PAWASKAR A,DAS M,et al.Resistance patterns among multidrug-resistant tuberculosis patients in greater metropolitan Mumbai: trends over time[J].PLoS One,2015,10(1):e0116798
[4] THEE S,GARCIA-PRATS AJ,DRAPER HR,et al.Pharmacokinetics and safety of moxifloxacin in children with multidrug-resistant tuberculosis[J].Clin Infect Dis,2015,60(4):549
[5] 唐神结,许绍发,李亮.耐药结核病学[M].北京:人民卫生出版社,2014:126
[6] 徐意,朱峰,黄振荣,等.莫西沙星对老年社区获得性肺炎患者抗感染疗效及肺功能的影响[J].中华医院感染学杂志,2018,28(4):485
[7] GUPTA UD,VEMURI N,GUPTA P,et al.Efficacy of moxifloxacin & econazole against multidrug resistant(MDR)Mycobacterium tuberculosis in murine model[J].Indian J Med Res,2015,142(3):323
[8] LOPEZ-GAVIN A,TUDO G,VERGARA A,et al.In vitro activity against Mycobacterium tuberculosis of levofloxacin, moxifloxacin and UB-8902 in combination with clofazimine and pretomanid[J].Int J Antimicrob Agents,2015,46(5):582
[9] 王述蓉,冯申奎,黄毅岚,等.莫西沙星与左氧氟沙星治疗耐多药肺结核的系统评价[J].中华医院感染学杂志,2015,25(15):3446
[10]朱刚.左氧氟沙星与莫西沙星治疗耐药性肺结核的疗效和安全性比较[J].中国药房,2016,27(18):2514
[11]桂徐蔚,沙巍.左氧氟沙星和莫西沙星治疗耐多药结核的疗效对比研究[J].中华结核和呼吸杂志,2014,37(11):873
[12]张延安.莫西沙星对耐多药肺结核患者血清C-反应蛋白和降钙素原的影响[J].山东医药,2014,54(25):57
[13]牛家峰,尚永明,吕纪玲,等.耐多药肺结核患者莫西沙星与卷曲霉素联用对炎性因子及免疫功能的影响[J].中华医院感染学杂志,2016,26(14):3138
[14]CARRAL N,LUKAS JC,OTEO I,et al.Impact of poor compliance with levofloxacin and moxifloxacin on respiratory tract infection antimicrobial efficacy:a pharmacokinetic/pharmacodynamic simulation study[J].Int J Antimicrob Agents,2015,45(1):79
[15]唐学文,贾运涛,田晓江,等.左氧氟沙星,莫西沙星和环丙沙星上市后安全警戒信号的挖掘与评价:基于真实世界不良反应研究[J].中国新药杂志,2018,27(5):596

备注/Memo

备注/Memo:
【基金项目】青海省科技支撑计划项目(2014-NS-122) 【作者简介】莫东军,男,1985年1月生,本科,主治医师,研究方向:结核的诊断和治疗,E-mail:415967961@qq.com
更新日期/Last Update: 2019-11-20