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目的 探讨初治痰涂片阳性老年肺结核患者的疗效、对抗结核药物的耐受性及左氧氟沙星的有效性和安全性。 方法 将 82例初治痰涂片阳性老年肺结核患者按 4:3分为治疗组和对照组进行 6个月的临床观察 (强化期 2个月 ,巩固期 4个月 )。治疗组选用可乐必妥 ,按 2HLEV/ 4HLE方案给药 ;对照组用吡嗪酰胺 ,按 2HLEZ/ 4HLE给药。 结果 治疗组和对照组 2个月痰菌阴转率分别为 72 7%和 6 3 3%(P >0 0 5 ) ,治疗 6个月痰菌阴转率分别为 88 6 %和 83 3%(P >0 0 5 ) ,胸部X线病灶吸收分别为 86 4 %和 86 7%(P >0 0 5 ) ,空洞闭合率分别为 30 0 %和 2 4 1%(P >0 0 5 ) ,药物副反应发生率分别为 2 5 5 %和 5 1 4 %(P <0 0 5 )。 结论 老年人肺结核治愈率较低 ,药物副反应发生率高 ,左氧氟沙星对老年人肺结核安全有效。
Objective To investigate the curative effect of anti-tuberculosis drugs and the efficacy and safety of levofloxacin in treating sputum smear-positive elderly pulmonary tuberculosis patients. Methods 82 cases of newly diagnosed sputum smear-positive elderly pulmonary tuberculosis patients were divided into treatment group and control group according to 4: 3 for 6 months clinical observation (2 months of strengthening and 4 months of consolidation). The treatment group cokebital, by 2HLEV / 4HLE program; control group with pyrazinamide, according to 2HLEZ / 4HLE administration. Results The sputum negative conversion rates in the two groups were 72.7% and 63.3% (P> 0.05), respectively, and the sputum negative conversion rates were 88.6% and 83.3% respectively for 6 months in the treatment group and the control group (P 0 05). The chest X-ray lesion absorption was 86 4% and 86 7% respectively (P 0 05), and the void closure rates were 30 0% and 24 1% respectively (P 0 05) The incidences of side effects of drugs were respectively 25.5% and 51.4% (P <0.05). Conclusion Elderly tuberculosis has a low cure rate and high incidence of side effects. Levofloxacin is safe and effective for tuberculosis in the elderly.