标题：莫西沙星与左氧氟沙星联合用药方案治疗耐多药肺结核疗效研究

      作者：方坚 1，廖亮 2，杜培 2    安康市中心医院感染性疾病科 1、呼吸内科 2，陕西 安康 725000

      卷次： 2020年31卷15期

      【摘要】 目的 比较莫西沙星联合用药方案与左氧氟沙星联合用药方案治疗耐多药肺结核(MDR-PTB)的临床疗效。方法 选择2015年1月至2018年1月期间安康市中心医院收治的136例MDR-PTB患者为研究对象，根据随机数表法将患者分为观察组67例和对照组69例，分别使用莫西沙星与左氧氟沙星联合多药治疗，疗程为18个月。比较两组患者治疗前后的血清肿瘤坏死因子-α (TNF-α)水平、第 1秒用力呼气量(FEV1)以及最大呼气流量(PEF)等肺功能指标，同时比较两组患者的临床疗效和相关不良反应发生情况。结果 治疗后，观察组患者的FEV1、PEF分别为(1.47±0.17) L、(7.62±1.35) L/s，明显高于对照组的(1.23±0.22) L、(6.19±1.22) L/s，血清TNF-α为(81.33±18.61) ng/mL，明显低于对照组的(95.72±24.40) ng/mL，差异均有统计学意义(P<0.05)；观察组患者的治疗总有效率为85.07%，明显高于对照组的68.12%，差异有统计学意义(P<0.05)；观察组和对照组患者的不良反应发生率分别为17.91%、15.94%，差异无统计学意义(P>0.05)。结论 莫西沙星联合多药治疗MDR-PTB在降低血清炎症因子、改善肺功能方面的作用明显优于左氧氟沙星，临床疗效显著，且具有较好的用药安全性。
      【关键词】 莫西沙星；左氧氟沙星；耐多药肺结核：肺功能；肿瘤坏死因子-α；疗效
      【中图分类号】 R521 【文献标识码】 A 【文章编号】 1003—6350（2020）15—1948—03

Comparative study of moxifloxacin versus levofloxacin in combination with multiple drugs in the treatment ofmultidrug-resistant pulmonary tuberculosis.
FANG Jian 1, LIAO Liang 2, DU Pei 2. Department of Infectious Diseases 1,Respiratory Department 2, Ankang Central Hospital, Ankang 725000, Shaanxi, CHINA
【Abstract】 Objective To compare the clinical efficacy of combined drug program of moxifloxacin versus levo-floxacin in the treatment of multidrug-resistant pulmonary tuberculosis (MDR-PTB). Methods A total of 136 cases ofMDR-PTB patients treated in Ankang Central Hospital from January 2015 to January 2018 were selected as the study ob-jects. According to the random number table method, the patients were randomly divided into the observation group (n=67) and the control group (n=69), which were treated with moxifloxacin and levofloxacin in combination with multipledrugs for 18 months, respectively. The changes of serum tumor necrosis factor-α (TNF-α), forced expiratory volume inone second (FEV1), and peak expiratory flow (PEF) were compared between the two groups before and after treatment,and the clinical efficacy and adverse drug reactions were also compared. Results After treatment, FEV1 and PEF in theobservation group were (1.47±0.17) L, (7.62±1.35) L/s, significantly higher than (1.23±0.22) L, (6.19±1.22) L/s in thecontrol group, and serum TNF-α was (81.33±18.61) ng/mL, significantly lower than (95.72±24.40) ng/mL in the controlgroup (P<0.05). The total effective rate in the observation group was 85.07%, significantly higher than 68.12% in thecontrol group (P<0.05). The incidence of adverse reactions showed no statistically significant difference between the ob-servation group and the control group (17.91% vs 15.94% , P>0.05). Conclusion Moxifloxacin in combination withmultiple drugs in the treatment of MDR-PTB is superior to levofloxacin combined with multiple drugs in reducing se-rum inflammatory factors and improving lung function, which improves the clinical efficacy and drug safety.
      【Key words】 Moxifloxacin; Levofloxacin; MDR-TB: Pulmonary function; TNF-α; Curative effect