张雪

[摘要] 目的 探討左氧氟沙星和卷曲霉素联合治疗对肺结核患者痰结核菌素转阴比率的影响。 方法 选取2018年9月至2019年9月我院收治的肺结核患者110例作为研究对象，随机分成观察组和对照组，每组各55例。对照组采用常规疗法，观察组采用左氧氟沙星和卷曲霉素联合治疗。治疗结束后，比较两组患者治疗后的痰菌转阴率、空洞闭合率以及病灶吸收率变化，比较两组患者治疗前后的免疫指标变化及临床常见不良反应发生率。 结果 治疗后，观察组患者的痰菌转阴率、空洞闭合率以及病灶吸收率均高于对照组，差异有统计学意义（P<0.05）;治疗前，两组患者CD4+、CD8+、CD3+以及CD4+/CD8+T比较，差异无统计学意义（P>0.05） ，治疗后，观察组CD4+及CD3+高于对照组，CD8+低于对照组，差异有统计学意义（P<0.05），治疗后两组CD4+/CD8+比较，差异无统计学意义（P>0.05）;治疗后，观察组不良反应总发生率低于对照组，差异有统计学意义（P<0.05）。 结论 左氧氟沙星与卷曲霉素联合治疗时，能够增强患者的痰菌转阴效率，提高空洞的闭合效果以及增大对病灶的吸收程度，值得临床应用。

[关键词] 左氧氟沙星;卷曲霉素;肺结核;痰结核菌素

[中图分类号] R521          [文献标识码] B          [文章编号] 1673-9701（2021）11-0108-04

Effect of levofloxacin combined with capreomycin on negative conversion ratio of sputum tuberculin in patients with pulmonary tuberculosis

ZHANG Xue

The Third Ward of Tuberculosis， the Tenth People′s Hospital of Shenyang City， Shenyang   110000， China

[Abstract] Objective To investigate the effect of levofloxacin combined with capreomycin on the negative conversion ratio of sputum tuberculin of tuberculosis patients. Methods A total of 110 patients with pulmonary tuberculosis admitted to our hospital from September 2018 to September 2019 were selected and they were randomly divided into the observation group and the control group， with 55 cases in each group. The control group was treated with conventional therapy， while the observation group was treated with levofloxacin and capreomycin. After treatment， the negative conversion ratio of sputum tuberculin， the cavity closure rate and the lesion absorption rate of the two groups were compared. Results After treatment， the negative conversion ratio of sputum tuberculin， the cavity closure rate and the lesion absorption rate in the observation group were higher than those in the control group， and the difference was statistically significant（P<0.05）. Before treatment， there was no significant difference in CD4+， CD8+， CD3+ and CD4+/CD8+ T between the two groups （P>0.05）. After treatment， CD4+ and CD3+ in the observation group were higher than those in the control group （P<0.05）， and CD8+ was lower than that in the control group（P<0.05）. There was no significant difference in CD4+/CD8+ after treatment between the two groups（P>0.05）. After treatment， the total incidence of adverse reactions in the observation group was lower than that in the control group， with significant difference（P<0.05）. Conclusion Levofloxacin combined with capreomycin can enhance the efficiency of the negative conversion ratio of sputum tuberculin， improve the cavity closure rate and increase the absorption degree of lesions， which is worthy of clinical application.

[Key words] Levofloxacin; Capreomycin; Tuberculosis; Sputum tuberculin

肺结核在临床治疗中属于难治愈类的肺部疾病，患有该类症状的患者通常情况下具有较长的临床病程并伴有纤维空洞现象的产生，同时在机体内会形成符合结核菌繁殖的内部生长环境，具有治疗闭合难度较大及出现巨大空洞等不良反应[1]。患者在发病后，由于不合理的用药或不规则使用，会容易在机体内产生较强的耐药性，促使患者的病情临床发生迁移现象，同时造成难治愈结果，严重的会危害患者的肺部功能，临床常使用卷曲霉素和左氧氟沙星进行联合治疗[2]。卷曲霉素在化学原理上属于环多肽类药物，可以有效治疗肺结核分枝杆菌等，能够对患者的病情转移及合成相关的蛋白质起到抑制作用，但临床使用卷曲霉素会造成患者听力减退[3]、体内电解质发生紊乱等不良反应。……