张雪

[摘要] 目的 探討左氧氟沙星联合利福贲丁治疗肺结核的临床疗效。 方法 选择2017年10月至2019年10月我院收治的100例肺结核患者，随机分为对照组与研究组，每组各50例，对照组治疗方案为2HRZE/4HRE，研究组治疗方案为2HLZV/4HL2V，比较两组不良反应发生情况和空洞愈合、病灶吸收、痰菌转阴等情况，比较两组体液免疫、细胞免疫指标。 结果 两组中个别患者出现白细胞减少、皮疹、发热等不良反应，研究组不良反应发生率为12.0%，低于对照组的40.0%，差异有统计学意义（P<0.05）;治疗2个月，研究组空洞愈合率（80.0%）、病灶吸收良好率（80.0%）、痰菌转阴率（84.0%）均高于对照组（56.0%、56.0%、60.0%）（P<0.05）;治疗6个月，研究组空洞愈合率（84.0%）、病灶吸收良好率（94.0%）、痰菌转阴率（90.0%）均高于对照组（60.0%、68.0%、68.0%）（P<0.05）;两组治疗后IgM、IgA、IgG、CD4+均高于治疗前，CD8+均低于治疗前（P<0.05）;研究组治疗后IgM、IgA、IgG、CD4+均高于对照组，CD8+低于对照组（P<0.05）。 结论 肺结核使用左氧氟沙星联合利福贲丁治疗，安全性较好，治疗效果较高，患者痰菌转阴、病灶吸收良好、空洞治愈效果显著提高，患者免疫功能有明显提升，疗效较满意，值得临床应用。

[关键词] 左氧氟沙星;利福贲丁;肺结核;不良反应

[中图分类号] R521          [文献标识码] B          [文章编号] 1673-9701（2021）12-0112-04

Discussion on clinical effect of levofloxacin combined with rifampicin in the treatment of tuberculosis

ZHANG Xue

Tuberculosis Ward Ⅲ， Shenyang Tenth People′s Hospital， Shenyang   110000， China

[Abstract] Objective To explore clinical effect of levofloxacin combined with rifampicin in the treatment of tuberculosis. Methods A total of 100 tuberculosis patients admitted to our hospital from October 2017 to October 2019 were selected and randomly divided into the control group and the study group， with 50 cases in each group. The control group was treated with 2HRZE/4HRE， and the study group was treated with 2HLZV/4HL2V. The rate of adverse reactions， cavity healing， lesion absorption and the negative conversion of sputum bacteria were compared between the two groups. The indicators of humoral immunity and cell-mediated immunity were compared between two groups. Results Some patients in the two groups had adverse reactions such as leukopenia， skin rash， fever， etc. The rate of adverse reactions in the study group was 12.0%，which was significantly lower than 40.0% in the control group， and the difference was statistically significant（P<0.05）. Two months after treatment， the cavity healing rate（80.0%）， the excellent rate of lesion absorption（80.0%）， and the negative rate of sputum bacteria（84.0%） in the study group were higher than those in the control group（56.0%， 56.0% and 60.0%）（P<0.05）. Six months after treatment， the cavity healing rate （84.0%）， the excellent rate of lesion absorption（94.0%），and the negative conversion ratio of sputum（90.0%） in the study group were higher than those in the control group（60.0%， 68.0% and 68.0%）（P<0.05）. IgM， IgA， IgG， CD4+ after treatment in the two groups were higher than those before treatment， and CD8+ was lower than that before treatment（P<0.05）. IgM， IgA， IgG， CD4+ were higher and CD8+ was lower in the study group than those in the control group after treatment（P<0.05）. Conclusion Levofloxacin combined with rifampicin has higher safety and better therapeutic effect in the treatment of tuberculosis. The negative conversion ratio of sputum bacteria， the focus absorption and the cavity healing were significantly improved， and the immune function of the patients was significantly enhanced， with a satisfactory curative effect.It is worthy of clinical application.

[Key words] Levofloxacin; Rifampicin; Tuberculosis; Adverse reaction

肺结核属于一种具有传染性的慢性疾病，痰菌培养呈阳性时被叫做菌阳肺结核，是由结核分杆菌所造成，控制结核病传播和流行的重要手段是对菌阳肺结核患者的有效治疗[1]。随着医学水平的不断发展，抗结核药物广泛应用，如链霉素、利福平、异烟肼等，肺结核的死亡率、发病率均有所降低[2]。但随着药物不规范使用、局部区域卫生水平较低、人口流动性增加等原因，结核病的发病率呈现逐年递增趋势，已成为重大社会公共卫生问题。结核病若无法及时有效的进行治疗，患者极易并发严重疾病，如肺癌、肺源性心脏病等，对患者的呼吸系统产生损害，危及患者生命安全，影响患者正常生活[3]。为了预防病菌进一步传播，探寻肺结核患者治疗的有效方法，本研究将左氧氟沙星联合利福贲丁应用在肺结核患者治疗中，分析其临床疗效，现报道如下。……