刘杰

摘要：目的  探讨静脉注射利福平联合抗结核药物治疗老年肺结核的疗效及对患者血清炎症因子水平的影响。方法  选取2016年3月～2017年4月我院收治的66例老年肺结核患者，采用随机数表法分为对照组和观察组，各33例。对照组在常规抗结核治疗基础上给予以口服利福平治疗，观察组在常规抗结核治疗基础上予以静脉注射利福平治疗。比较两组不同时间段痰菌阴转率、临床疗效、血清炎症因子水平。结果  观察组治疗后第1个月、3个月、6个月的痰菌阴转率分别为36.36%、63.64%、93.94%，均高于对照组15.15%、36.36%、72.73%（P<0.05）;观察组临床总有效率为93.94%，高于对照组72.73%（P<0.05）;治疗后，观察组血清TNF-α、IL-6、IL-10水平均低于对照组（P<0.05）。结论  静脉注射利福平可提高老年肺结核患者痰菌阴转率，降低血清炎症因子，提高临床疗效。

关键词：静脉注射;利福平;老年人;肺结核;炎症因子

中图分类号：R521                                  文獻标识码：A                                   DOI：10.3969/j.issn.1006-1959.2019.18.048

文章编号：1006-1959（2019）18-0142-02

Abstract：Objective  To investigate the efficacy of intravenous rifampicin combined with anti-tuberculosis drugs in the treatment of senile pulmonary tuberculosis and its effect on serum inflammatory factor levels.Methods  66 elderly patients with pulmonary tuberculosis admitted to our hospital from March 2016 to April 2017 were randomly divided into the control group and the observation group， with 33 cases in each group. The control group was treated with oral rifampicin on the basis of conventional anti-tuberculosis treatment， and the observation group was given intravenous rifampicin on the basis of conventional anti-tuberculosis treatment. The sputum negative conversion rate， clinical efficacy and serum inflammatory factor levels were compared between the two groups.Results  The negative conversion rates of sputum in the observation group were 36.36%， 63.64% and 93.94% at the first month， 3 months and 6 months after treatment， respectively， which were higher than the control group 15.15%， 36.36% and 72.73%（P<0.05）. The total effective rate of the observation group was 93.94%， which was higher than that of the control group 72.73%（P<0.05）. After treatment，The levels of serum TNF-α， IL-6 and IL-10 in the observation group were lower than those in the control group（P<0.05）.Conclusion  Intravenous rifampicin can improve the rate of sputum negative conversion， reduce serum inflammatory factors and improve clinical efficacy in elderly patients with pulmonary tuberculosis.

Key words：Intravenous injection;Rifampicin;Elderly;Tuberculosis;Inflammatory factors

肺结核（tuberculosis）是临床常见的一种因结核分枝杆菌感染引起的呼吸道传染病，可导致患者机体免疫功能降低，严重威胁人类的健康。老年患者多合并有肺心病、慢性支气管炎等多种慢性基础疾病，导致老年人群为肺结核病的易感人群[1]。由于老年患者年老体弱、对抗结核药物较敏感等特点，服用抗结核药物可能会出现一系列的不良反应，导致耐受性差。本研究采用静脉注射利福平治疗老年肺结核，探讨其临床疗效以及对患者血清炎症因子水平的影响，现报告如下。

1资料与方法

1.1一般资料  选取2016年3月～2017年4月佳木斯市肿瘤结核医院收治的66例老年肺结核患者作为研究对象。本研究经医院伦理委员会审批，患者自愿签署知情同意书。纳入标准：①均符合《肺结核诊断和治疗指南》中对肺结核的诊断标准[2];②年龄≥65岁。……