瞿志军+李国航+庄桂龙+余希+朱难兰

[摘要]目的 探讨加替沙星治疗复治肺结核的临床效果。方法 选取2013年1月～2016年3月我院收治的100例复治肺结核患者作为研究对象，采取计算机随机序列法将患者随机分为两组，每组50例。对照组实施常规抗结核治疗，观察组在常规抗结核治疗的同时给予加替沙星治疗。比较两组患者的痰菌转阴率、病灶总吸收率、不良反应发生率以及免疫功能指标。结果 观察组的痰菌转阴率、病灶总吸收率明显高于对照组（P<0.05），不良反应发生率明显低于对照组（P<0.05）。与治疗前比较，两组患者治疗后的免疫功能指标均明显下降（P<0.05），但治疗后，观察组的免疫功能指标均高于对照组（P<0.05）。结论 加替沙星治疗复治肺结核具有显著的临床效果，可有效促进痰菌转阴、病灶吸收，还可减少不良反应，提高免疫功能。

[关键词]复治肺结核；抗结核治疗；加替沙星

[中图分类号] R521.9 [文献标识码] A [文章编号] 1674-4721（2017）01（c）-0101-03

[Abstract]Objective To explore the clinical effect of Gatifloxacin treating retreatment pulmonary tuberculosis.Methods 100 cases with retreatment pulmonary tuberculosis treated by our hospital from January 2013 to March 2016 were selected as the research objects and they were randomly divided into two groups by taking the computer random sequence method，each group had 50 cases.The control group received routine anti tuberculosis treatment，while the observation group received Gatifloxacin treatment on the basic of routine anti tuberculosis treatment.The negative conversion rate of sputum bacterium，the total absorption rate of the focus，the incidence rate of adverse reaction and immune function indexes were compared between two groups.Results The negative conversion rate of sputum bacterium，the total absorption rate of the focus in the observation group were significantly higher than those in the control group （P<0.05），and the incidence rate of adverse reaction was significantly lower than that in the control group （P<0.05）.Compared with before treatment，the immune function indexes in the two groups after treatment were decreased significantly （P<0.05），but the immune function indexes in the observation group after treatment were higher than those in the control group （P<0.05）.Conclusion Gatifloxacin treating retreatment pulmonary tuberculosis has significant clinical effect，and can effectively promote the sputum bacterium for negative-conversing and the absorption of focus，but also can reduce the adverse reaction，improve immune function.

[Key words]Retreatment pulmonary tuberculosis；Anti tuberculosis treatment；Gatifloxacin

复治肺结核主要是指在治疗后出现复发的肺结核，其发生与日益增多的结核病耐藥菌株有关，是当前肺结核防治中亟待解决的重点问题和难点问题，因此，临床上应对复治肺结核进行更加深入的研究，积极寻找有效的治疗方法[1-2]。由于复治肺结核患者往往产生结核病耐药菌株，采用常规抗结核治疗方案继续治疗无法取得满意的效果，故有必要寻求新药进行治疗。诸多临床研究报道指出，喹诺酮类药物可抑制结核分枝杆菌的突变性，与抗结核药物联合应用不仅不会影响药效，还会在一定程度上提高抗结核的治疗效果[3]。加替沙星属于新一代喹诺酮类药物，在肺结核的临床治疗中有所应用，我院在复治肺结核患者的抗结核治疗过程中尝试加用加替沙星治疗，效果较好，现报道如下。

1资料与方法

1.1一般资料

选取2013年1月～2016年3月我院收治的100例复治肺结核患者作为研究对象，所有患者均具有肺结核治疗史，痰菌转阴后再次出现复发。……