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目的观察利福喷汀与左氧氟沙星联合治疗老年初治涂阳肺结核的疗效。方法 76例老年初治涂阳肺结核患者随机分为治疗组(2HL2VE/4HL2)和对照组(2HRZE/4HR),观察痰菌阴转率、X线有效率和药物不良反应。结果治疗组34例和对照组30例完成疗程。2个月、3个月和疗程结束治疗组痰菌阴转率分别为79.4%、82.4%和91.2%。对照组分别为76.7%、80.0%和90.0%,(均P>0.05);X线有效率分别为94.1%和93.3%(P>0.05);空洞闭合率分别为31.8%和25.0%(P>0.05);2组差异都无显著性意义。肝功能损害导致退组分别为1例和6例,2组差异有显著性意义(2.6%比15.8%,χ2=3.93,P<0.05)。结论利福喷汀联合左氧氟沙星治疗老年初治涂阳肺结核疗效相近,不良反应少。
Objective To observe the efficacy of rifapentine combined with levofloxacin in the treatment of smear positive pulmonary tuberculosis in the elderly. Methods Seventy-six elderly patients with smear-positive pulmonary tuberculosis were randomly divided into treatment group (2HL2VE / 4HL2) and control group (2HRZE / 4HR). The sputum negative conversion rate, X-ray effective rate and adverse drug reaction were observed. Results The treatment group of 34 patients and control group of 30 patients completed the course of treatment. The negative conversion rates of sputum in two months, three months and the end of treatment were 79.4%, 82.4% and 91.2% respectively. (P> 0.05). The effective rate of X-ray was 94.1% and 93.3% respectively (P> 0.05), and the void closure rates were 31.8% and 25.0% (P> 0.05). There was no significant difference between the two groups. Liver damage resulted in 1 and 6, respectively. The difference between the two groups was significant (2.6% vs 15.8%, χ2 = 3.93, P <0.05). Conclusion The efficacy of rifapentine combined with levofloxacin in the treatment of smear positive pulmonary tuberculosis in the elderly is similar with less adverse reactions.