目的 探討不同療程左氧氟沙星聯(lián)合四聯(lián)抗結(jié)核藥治療結(jié)核性胸膜炎的療效及不良反應(yīng)。方法 168例結(jié)核性胸膜炎患者隨機(jī)分為治療組與對照組,各84例。兩組均用標(biāo)準(zhǔn)四聯(lián)抗結(jié)核藥治療,對照組(長療程)在此基礎(chǔ)上靜脈滴注左氧氟沙星0.6 g/次,1次/d,共4周;治療組(短療程)加用相同劑量的左氧氟沙星1周,比較兩組的療效與不良反應(yīng)。結(jié)果 治療組與對照組的有效率分別為88.1%、89.3%,兩組比較差異無統(tǒng)計(jì)學(xué)意義;隨訪期間對照組無1例復(fù)發(fā),治療組有1例復(fù)發(fā),兩組比較差異無統(tǒng)計(jì)學(xué)意義;兩組胸腔積液消失時間差異無統(tǒng)計(jì)學(xué)意義。對照組不良反應(yīng)發(fā)生率為15.5%,治療組的為7.1%,兩組比較差異有統(tǒng)計(jì)學(xué)意義(χ²=2.583,P < 0.05)。結(jié)論 雖然短療程與長療程左氧氟沙星治療結(jié)核性胸膜炎的效果無顯著性差異,但短療程的不良反應(yīng)發(fā)生率較低,值得臨床推廣應(yīng)用。

Objective To discuss the efficacy on tuberculous pleurisy cured by different courses of treatment of levofloxacin combined with anti-tuberculosis drugs. Methods Patients (168 cases) were randomly divided into long course group and short course group and 84 patients were in each group. The patients in both groups were cured by standard four anti-tuberculosis drugs combination. On this bases, the patients in long course group were treated with levofloxacin for 4 weeks, and the patients in short course group were treated with levofloxacin for 1 week. The efficacy and adverse reaction were compared between two groups. Results The efficiencies in long course and short course groups were 88.1% and 89.3%, respectively. The difference was not statistically significant. There was no patient in short course group relapse, but one patient in long course group relapsed. The difference was not statistically significant. The incidence rates of adverse reaction in long course and short course groups were 15.5% and 7.1%, respectively. The difference was statistically significant(χ²=2.583, P < 0.05). Conclusion Compared to long course group, the efficacy of short course group on tuberculous pleurisy has no significant difference, but the incidence rate of adverse reaction is lower, it is worthy of clinic application.

延安市科學(xué)技術(shù)研究發(fā)展計(jì)劃項(xiàng)目(2012YDFY-Y302)