李冶

[摘要] 目的 分析磷霉素與加替沙星联用治疗肺结核合并下呼吸道感染的疗效。 方法 在我院2019年1月至2020年4月诊治的肺结核合并下呼吸道感染患者中选出142例为研究对象，采用随机数字表法分为对照组与试验组，每组各71例，对照组应用抗痨化疗和加替沙星治疗，试验组加用磷霉素治疗，比较两组的总有效率、血清炎症细胞因子水平、临床症状缓解时间及不良反应发生率。 结果 两组的总有效率比较，差异有统计学意义（P<0.05）;试验组治疗2周后的血清PCT、IL-6、CRP水平均低于对照组，差异有统计学意义（P<0.05）;试验组的临床症状消失时间（发热、咳嗽咳痰、肺部湿啰音）均短于对照组，差异有统计学意义（P<0.05）;两组不良反应总发生率比较，差异无统计学意义（P>0.05）。 结论 加替沙星联合磷霉素配合抗痨化疗方案用于肺结核合并下呼吸道感染治疗中效果肯定，有助于促进患者感染症状缓解，降低炎症反应，疗效可靠安全。

[关键词] 磷霉素;加替沙星;肺结核;下呼吸道感染;炎症反应;不良反应

[中图分类号] R521          [文献标识码] A          [文章编号] 1673-9701（2021）35-0016-04

Observation on the efficacy of fosfomycin combined with gatifloxacin injection on pulmonary tuberculosis complicated with lower respiratory tract infection

LI Ye

Integrated Lung Cancer Center， Shenyang Tenth People′s Hospital， Shenyang   110044， China

[Abstract] Objective To investigate the efficacy of fosfomycin combined with gatifloxacin on pulmonary tuberculosis complicated with lower respiratory tract infection. Methods A total of 142 patients with pulmonary tuberculosis complicated with lower respiratory tract infection treated in our hospital from January 2019 to April 2020 were selected as the study objects， and they were divided into the control group （n=71） and the experimental group （n=71） according to the random number table method. The control group was treated with conventional antituberculosis chemotherapy combined with gatifloxacin， while the experimental group was treated with fosfomycin on the basis of the control group. The total effective rate， serum inflammatory cytokines levels， clinical symptom relief time and incidence of adverse reactions were compared between the two groups. Results The total effective rate of the two groups was significantly different （P<0.05）. After 2 weeks of treatment， the levels of serum PCT， IL-6 and CRP in the experimental group were all lower than those in the control group，the difference was statistically significant （P<0.05）. The recovery time of body temperature， disappearance time of cough and expectoration， disappearance time of pulmonary moist rales in patients of the experimental group were all shorter than those of the control group，the difference was statistically significant （P<0.05）. There was no significant difference in the total incidence of adverse reactions between two groups （P>0.05）. Conclusion The application of fosfomycin combined with gatifloxacin injection in patients with pulmonary tuberculosis complicated with lower respiratory tract infection is effective， which is conducive to relieving the symptoms of infection and inflammatory reaction. Meanwhile， the combined medication is highly safe and worthy of promotion.

[Key words] Fosfomycin; Gatifloxacin; Pulmonary tuberculosis; Lower respiratory tract infection; Inflammatory reaction; Adverse reactions

由于肺結核是一种慢性的消耗型疾病，随着病程的发展，患者多伴有免疫功能损伤;加上患者长期应用抗结核药物，因此极易出现下呼吸道感染并发症。一旦合并下呼吸道感染，将会直接导致病情恶化，增加治疗难度，严重时会危及患者的生命安全[1-3]。抗生素抗菌治疗是治疗的基础和关键，磷霉素是近年来应用的一种抗生素，其抗菌作用独特，对于引起下呼吸道感染的常见病原菌有较好的抗菌活性，且该药与其他常用抗生素之间无交叉耐药性[4-5]。……