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目的探讨采用左氧氟沙星对初治涂阳肺结核的疗效。方法将2016年1月—5月在结核病防治科登记治疗的120例初治涂阳肺结核患者随机分为3组,分别以A组(左氧氟沙星组)4HRZEL/2HR,B组(强化期延长方案组)4HRZE/2HR,C组(标准方案组)2HRZE/4HR方案进行6个月抗结核治疗。结果 3组2月末痰培养阴转率分别为91.7%,77.1%,82.9%,5月末痰培养阴转率分别为100.0%,91.4%,85.7%,6月末痰培养阴转率分别为100.0%,94.3%,88.6%,3组间痰菌阴转率差异无统计学意义(P>0.05)。3组6月末病灶明显吸收率分别为80.6%,54.3%,45.7%,A组明显高于B组和C组(P<0.05)。3组6月空洞闭合率分别为95.0%,75.0%,62.5%,A组高于C组(P<0.05),但与B组比较差异无统计学意义(P=0.077)。结论 4HRZEL/2HR治疗方案可提高初治涂阳肺结核治愈率和病灶吸收率,但仍需进一步研究。
Objective To investigate the efficacy of levofloxacin on smear-positive pulmonary tuberculosis. Methods A total of 120 newly diagnosed smear-positive pulmonary tuberculosis patients who were enrolled in TB department from January to May 2016 were randomly divided into three groups: A group (levofloxacin group), 4HRZEL / 2HR group B (intensive phase prolongation group ) 4HRZE / 2HR, Group C (standard regimen) 2HRZE / 4HR regimen for 6 months. Results The negative conversion rates of sputum culture in the three groups at the end of February were 91.7%, 77.1% and 82.9% respectively. The negative conversion rates of sputum culture at the end of May were 100.0%, 91.4% and 85.7% respectively. The negative conversion rates of sputum culture at the end of June were 100.0% , 94.3%, 88.6% respectively. There was no significant difference in sputum negative conversion rate among the three groups (P> 0.05). The apparent absorption rate of lesions in the three groups at the end of June was 80.6%, 54.3% and 45.7% respectively, which was significantly higher in group A than in group B and C (P <0.05). The closing rates of void in June were 95.0%, 75.0% and 62.5% respectively in group A, but higher in group A than in group C (P <0.05), but there was no significant difference compared with group B (P = 0.077). Conclusion The treatment of 4HRZEL / 2HR can improve the cure rate and absorption rate of smear-positive pulmonary tuberculosis. However, further study is needed.