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对氨基水杨酸异烟肼+左氧氟沙星+乙胺丁醇+链霉素方案治疗初治肺结核并存慢性乙型肝炎临床观察
彭东东，王冬敏，李鸿槟，林健雄彭东东、王冬敏、李鸿槟、林健雄，广东省 汕头市结核病防治所，515031
基金项目： 广东省科技厅立项课题(2007B031404003)；广东省医学科学技术研究基金资助项目(A2007619)
摘 要:目的 观察和评价对氨基水杨酸异烟肼(商品名：力克菲蒺)、左氧氟沙星、乙胺丁醇、链霉素方案治疗初治肺结核并存慢性乙型肝炎的疗效和安全性。方法 将初治肺结核并存慢性乙型肝炎60例随机分为治疗组30例和对照组30例；化疗方案：治疗组用力克菲蒺、左氧氟沙星、乙胺丁醇、链霉素；对照组用异烟肼、利福平、吡嗪酰胺、乙胺丁醇，疗程均为9个月。结果 共有55例患者完成化疗疗程(治疗组28例和对照组27例)，治疗9个月后治疗组痰菌阴转率为96.4%，对照组为92.6%；疗程结束时治疗组和对照组病灶吸收有效率分别为96.4%和96.3%；两组在疗效上差异无统计学意义(P＞0.05)；2年复查，治疗组和对照组痰菌复阳率分别为3.5%和3.7%，差异无统计学意义(P＞0.05)。两组肝功能损害治疗组为14.3%，对照组为66.7%，在肝功能损害上差异有统计学意义(P＜0.01)。结论 力克菲蒺、左氧氟沙星、乙胺丁醇、链霉素方案治疗初治肺结核并存慢性乙型肝炎的疗效确切且较安全。
关键词:结核，肺； 肝炎，乙型，慢性； 药物疗法，联合
Clinical observation on the clinical efficacy and safety of the regimen of pasiniazid levofloxcin ethambutol streptomycin′ for lesions of the new pulmonary tuberculosis complicated with chronic hepatitis B
PENG Dong-dong，WANG Dong-min，LI Hong-bin，LIN Jian-xiong.Prophylactico-therapetic Institution of Tuberculosis of Shantou，Shantou 515031，China
Abstract:Objective To observe the clinical efficacy and safety of the treatment regimen of “Pasiniazid Levofloxcin Ethambutol Streptomycin” for lesions of the new pulmonary tuberculosis complicated with chronic hepatitis B.Methods By random group-matching,60 cases with lesions of the new pulmonary tuberculosis complicated with chronic hepatitis B were divided into the treatment group(30 cases) and control group(30 cases).The chemotherapy regimen adopted：the treatment group used Pasiniazid (D)， Levofloxcin (V)， Ethambutol (E)， Streptomycin (S)， while the control group used Isoniazid (H)，Rifampicin (R)，Pyrazinamide (Z) and Ethambutol (E).The course of treatment was 9 months for both groups.Results Fifty-five cases completed the treatment with 28 cases in the treatment group and 27 cases in the control group.In the treatment group，the sputum negative conversion rate by the end of the 9th month was 96.4% in smear；while in the control group，the rates were 92.6% respectively.At the end of the treatment，X-rays evidently improved the assimilation of focuses up to 96.4% in the treatment group and 96.3% in the control group；there was no significant difference in the treatment outcome in the two groups (P＞0.05).The re-checking in 2 years showed that the positive conversion rate was 3.5% in treatment group and 3.7% in control group with no significant difference between the two groups.The lesions of the liver was 14.3% in the treatment group and 66.7% in the control group with significant difference in the two groups(P＜0.01).Conclusions The regimen of “Pasiniazid Levofloxcin Ethambutol Streptomycin” scheme is effective and reliable to cure lesions of the new pulmonary tuberculosis complicated with chronic hepatitis B and it is easy to expand the application of this regimen in the clinical practice.
Key words:Tuberculosis，pulmonary； Hepatitis B，chronic； Drug therapy，combination
文献标引:彭东东，王冬敏，李鸿槟，林健雄.对氨基水杨酸异烟肼+左氧氟沙星+乙胺丁醇+链霉素方案治疗初治肺结核并存慢性乙型肝炎临床观察[J/CD].中华临床医师杂志：电子版,2010,4(7):920-923.
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