目的 對(duì)比分析吡嗪酰胺和左氧氟沙星治療肺結(jié)核合并糖尿病的臨床療效。方法 以入院病例號(hào)為編號(hào)，根據(jù)隨機(jī)數(shù)字表，將169名肺結(jié)核合并糖尿病患者隨機(jī)分成兩組，對(duì)照組84例，觀察組85例。對(duì)照組采用吡嗪酰胺治療，觀察組采用左氧氟沙星治療。檢測(cè)治療前后尿素氮（BUN）、肌酐（Scr）、血尿酸（BUA）和血藥峰濃度；取患者晨起清潔中斷晨尿，檢測(cè)尿微量白蛋白（mAlb）。進(jìn)行痰涂片檢查，觀察痰菌減少情況。結(jié)果 對(duì)照組患者治療后BUA檢測(cè)值明顯高于治療前（P<0.01）；且治療后觀察組BUA檢測(cè)值明顯低于對(duì)照組（P<0.01）。對(duì)照組患者治療后mAlb檢測(cè)值明顯高于治療前（P<0.05）；且治療后觀察組患者mAlb明顯低于對(duì)照組（P<0.05）。治療后觀察組痰菌轉(zhuǎn)陰率為81.18%，明顯高于對(duì)照組的57.14%（P<0.05）。治療后觀察組血藥峰濃度為（14.03±1.12）μg/mL，明顯高于對(duì)照組的（9.12±2.34）μg/mL（P<0.05）。結(jié)論 左氧氟沙星治療肺結(jié)核合并糖尿病療效顯著，且較吡嗪酰胺治療腎臟損傷小，但在血藥峰濃度升高時(shí)應(yīng)密切觀察不良反應(yīng)。

Objective To explore the clinical curative effect of Pyrazinamide and Levofloxacin in the treatment of tuberculosis combined with diabetes. Methods Totally 169 patients with pulmonary tuberculosis complicated with diabetes mellitus were randomly divided into control group and observation group. The patients in control group were given Pyrazinamide and the patients in observation group were given Levofloxacin. Before and after treatment, the concentration of urea nitrogen (BUN), creatinine (Scr), serum uric acid (BUA), urine trace albumin (mAlb), and serum peak was detected. Sputum smear examination were used to observe the situation of sputum bacteria. Results The detection value of BUA in the control group was significantly higher than that before treatment (P<0.01); and the BUA value of the observation group was significantly lower than that of the control group (P<0.01). The detection value of mAlb in the control group was significantly higher than that before treatment (P<0.05), and the mAlb in the observation group was significantly lower than that in the control group (P<0.05). After treatment, the sputum negative conversion rate in the observation group was 81.18%, which was significantly higher than that of 57.14% in the control group (P<0.05). After treatment, the blood concentration of the observation group was (14.03±1.12) μg/mL, which was significantly higher than that of the control group (9.12±2.34) μg/mL (P<0.05). Conclusion Levofloxacin shows better therapeutic effect and lower rate to cause kidney damage on tuberculosis combining with diabetes compared with Pyrazinamide, but the adverse reactions should be closely observed on the rising of peak concentration in blood.