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目的观察“力克肺疾、利福喷汀、阿米卡星、左氧氟沙星”方案对肝功损害肺结核的疗效及安全性。方法对肝功损害肺结核100例采用随机配对分组法分为治疗组(50例)和对照组(50例)。化疗方案:治疗组用力克肺疾(D)、利福喷汀(L)、阿米卡星(K)、左氧氟沙星(V);对照组用异烟肼(H)、利福平(R)、阿米卡星(K)、吡嗪酰胺(Z),疗程均为9个月。结果共有96例患者完成化疗疗程,治疗组49例和对照组47例,治疗9个月后治疗组涂阳阴转率为95.0%,培阳阴转率96.4%;对照组涂阳阴转率为94.4%,培阳阴转率95.7%。疗程结束时治疗组和对照组X线病灶有效率分别为98.0%和97.9%;空洞闭合率分别为61.5%和57.1%;2组在疗效上无显著性差异(P>0.05);2年复查,治疗组和对照组痰菌复阳率分别为3.7%和4.5%无显著性差异(P>0.05)。2组肝功能损害治疗组为32.0%,对照组为58.0%,在肝损害上有显著性差异(P<0.01)。结论“DLKV”方案对肝功能损害肺结核疗效确切且较安全。
Objective To observe the efficacy and safety of “Lectra Pulmonary Disease, Rifapentine, Amikacin and Levofloxacin” regimen on pulmonary tuberculosis with liver damage. Methods One hundred cases of pulmonary tuberculosis with liver damage were divided into treatment group (50 cases) and control group (50 cases) by random matching method. Chemotherapy regimen: The patients in the treatment group were treated with isoflurane (R), rifapentine (L), amikacin (K), and levofloxacin , Amikacin (K), pyrazinamide (Z), the course of treatment was 9 months. Results A total of 96 patients completed chemotherapy, 49 cases in the treatment group and 47 cases in the control group. After 9 months of treatment, the smear-negative conversion rate in the treatment group was 95.0% and the negative conversion rate in culture-yang was 96.4%. In the control group, 94.4%, negative conversion rate of 95.7%. At the end of treatment, the effective rates of X-ray lesion in the treatment group and the control group were 98.0% and 97.9% respectively; the void closure rates were 61.5% and 57.1% respectively; there was no significant difference between the two groups in curative effect (P> 0.05) , And no significant difference between the treatment group and the control group (3.7% vs 4.5%, respectively) (P> 0.05). The liver damage in the two groups was 32.0% in the treatment group and 58.0% in the control group, with significant difference in liver damage (P <0.01). Conclusion “DLKV” regimen is effective and safe for liver dysfunction of pulmonary tuberculosis.