曹青山等

【摘要】 目的 观察莫西沙星在耐多药肺结核病治疗方面的临床疗效及安全性。方法 將2010年6月～2013年5月期间新乡医学院第一附属医院河南省结核病院收治的88例耐多药肺结核病患者随机分为治疗组（44例）和对照组（44例），治疗组患者应用含莫西沙星方案；对照组应用含左氧氟沙星方案，疗程结束后，两组进行对比观察。结果 治疗组和对照组的治疗总有效率分别为90.91%和63.64%；痰菌转阴率分别为93.18%和65.91%，差异有统计学意义（P<0.05）；病灶吸收率分别为84.10%和56.82%，差异有统计学意义（P<0.05）；空洞闭合率分别为87.80%和45.00%，差异有统计学意义（P<0.05）；不良反应发生率分别为29.55%和40.91%，差异无统计学意义（P>0.05）。结论 相对左氧氟沙星而言，莫西沙星治疗耐多药肺结核病的疗效、痰菌转阴率比较好，不良反应发生率较低。

【关键词】莫西沙星；耐多药肺结核病；疗效观察

【Abstract】 Objective To observe the clinical efficacy and safety of moxifloxacin in the treatment of MDR-PTB.Methods According to the different treatment methods，Totally 88 Patients with MDR-PTB，who were randomly divided into treatment group（44 cases）and control group （44 cases） In our hospital During the period from 2010 June to 2013 May .The patient were given moxifloxacin，0.4g，once a day，The Patient were given levofloxacin，0.6g，once a day.All patients were treated for 18 months.The two groups also are combined with other types of antituberculosis drugs.Result After the end of treatment，The total efficiency of treatment group and control group respectively were90.91% and 63.64%， the difference was statistically significant （P<0.05）； the sputum negative conversion rate respectively were 93.18% and 72.73%， the difference was statistically significant （P<0.05）； the focus absorption rate respectively were 84.10% and 56.82%， the difference was statistically significant （P<0.05）； cavity closure rate respectively were 87.80% and 45.00%， the difference was statistically significant （P<0.05）；The incidence of adverse reaction respectively were 29.55% and 40.91%， there was no significant difference （P>0.05）. Conclusion The curative effect and the sputum negative conversion rate of moxifloxacin are superior to those of levofloxacin，and the adverse reactions of moxifloxacin rate is lower.

【key words 】 moxifloxacin； multi drug resistant pulmonary tuberculosis； curative effect observation

【中图分类号】R521 【文献标识码】B【文章编号】1004-4949（2015）02-0003-01

科研项目及编号：河南省科技厅 聚乙烯吡络酮碘胸腔注药治疗结核性包裹性胸膜炎 0624410104

在世界范围内，结核病仍然是威胁着人类健康的主要传染病之一，耐药结核分枝杆菌的存在和传播，不仅导致结核病治疗失败，在一定程度上也加重了全球的结核病疫情 ， 耐药菌感染引发的结核病严重威胁着这类病人的身心健康[1]，甚至预后非常差。迄今为止，治疗上关于该病的治疗尚缺乏理想化的根治方法[2]。目前，全球有2000多万结核患者，我国有600多万患者，而我国肺结核耐药率达到了27.8%[3]。耐多药肺结核病是指患者体内排出的结核菌至少对异烟肼、利福平耐药或同时对异烟肼、利福平、链霉素、吡嗪酰胺、乙胺丁醇中的三种或三种以上的药物耐药。本研究旨在比较莫西沙星与左氧氟沙星治疗耐多药肺结核病的安全性及临床疗效，报告如下。……