目的 了解阿莫西林克拉维酸钾联合抗结核药治疗青年耐多药肺结核的疗效及其不良反应,为治疗耐多药肺结核提供参考依据。方法 107例患者被随机分为对照组52例和观察组55例,对照组采用常规的抗结核药治疗,给予左氧氟沙星、对氨基水杨酸异烟肼、阿米卡星、丙硫异烟胺和乙胺丁醇,观察组在对照组用药的基础上另给予阿莫西林克拉维酸钾,疗程均为18个月,观察并比较两组的痰菌阴转、病灶吸收、空洞闭合和不良反应发生情况。结果 治疗第3、9、12、18个月,观察组的痰菌阴转率分别为52.73%、67.27%、76.36%和85.45%,均明显高于对照组的32.69%、46.15%、57.69%和65.38%(P<0.05);疗程结束时,观察组的病灶吸收率和空洞闭合有效率分别为87.27%和74.55%,均明显高于对照组的67.31%和44.23%(P<0.05);两组的不良反应发生率差异无统计学意义。结论 应用阿莫西林克拉维酸钾联合抗结核药治疗青年耐多药肺结核是有效、安全的。
Abstract
Objective To investigate the efficacy and adverse reactions of amoxicillin clavulanate potassium combined with anti-tuberculosis drugs in the treatment of multidrug-resistant tuberculosis (MDR-TB) in young patients for providing reference for the treatment of MDR-TB. Methods 107 MDR-TB patients were randomly divided into control group (n = 52) and observation group (n = 55). The control group was treated with conventional anti-tuberculosis drugs, which was given levofloxacin, isoniazid aminosalicylate, amikacin, prothionamide and ethambutol. The observation group received amoxicillin clavulanate potassium based on the same medication of the control group. The treatment course of the two groups was 18 months. The change of sputum negative conversion, lesion absorption, cavity closure and adverse reactions were observed and compared between the two groups. Results At the end of the third, ninth, twelfth and eighteenth month, the sputum negative rates were respectively 52.73%, 67.27%, 76.36% and 85.45% in the observation group, which were significantly higher than those in the control group by 32.69%, 46.15%, 57.69% and 65.38% (P<0.05). At the end of the treatment course, the rates of lesion absorption and cavity closure in the observation group were respectively 87.27% and 74.55%, which were significantly higher than those in the control group by 67.31% and 44.23% (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups. Conclusion It was effective and safe that amoxicillin clavulanate potassium was combined with anti-tuberculosis drugs in the treatment of MDR-TB in young patients.
关键词
阿莫西林克拉维酸钾 /
常规治疗 /
耐多药肺结核 /
联合化疗 /
疗效评价 /
青年
Key words
Amoxicillin clavulanate potassium /
Conventional treatment /
Multidrug-resistant tuberculosis /
Combined chemotherapy /
Efficacy evoluation /
Youth
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基金
福建省卫生计生委青年科研课题(2014-2-9)
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