摘要: |
目的评价利奈唑胺(Linezolid,Lzd)治疗耐药结核病(DR-TB)的临床疗效和安全性。方法收集2014年5月至2016年5月我院10例采用含利奈唑胺为主的化疗方案治疗的耐药肺结核患者诊治资料,分析其临床疗效及用药安全性。结果 10例患者临床症状症状均有不同程度改善。8例患者治疗后复查胸CT肺部病灶有吸收好转,空洞缩小,其中4例患者空洞闭合(最短时间2个月,最长时间9个月)。6例痰涂片阳性患者中有4例患者痰抗酸染色涂片阴转,阴转时间为30~210d,2例患者治疗后无咳痰症状,未送痰查抗酸杆菌涂片。9例治疗前2个月内痰结核分枝杆菌培养阳性患者中有3例患者痰培养阴转,阴转时间为31~202d,6例患者治疗后无咳痰症状,未送痰查分支杆菌培养。治疗过程中1例出现肝功损害,1例出现末梢神经炎,1例出现视力下降,停药后症状均改善;1例出现血小板轻度下降,1例出现轻微恶心、呕吐,继续治疗未进一步加重。结论利奈唑胺治疗DR-TB可明显改善患者的临床症状,促进肺部病灶吸收和空洞闭合,加速痰菌阴转,提高DR-TB患者的生活质量,不良反应较轻且基本能耐受,在耐药结核病治疗中有较大使用价值。 |
关键词: 耐药结核病 利奈唑胺 有效性 安全性 不良反应 |
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基金项目:成都市科技局科研项目(编号:2013-HM01-00177-SF) |
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Evaluation of Clinical Efficacy and Safety of Linezolid in the Treatment of Drug Resistant Tuberculosis |
Yang Ming;Liang Zongan;Yuan Ping1,2
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1.West China Hospital,Sichuan University;2.Department of tuberculosis,Chengdu public health clinical medical center
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Abstract: |
Objective To evaluate the efficacy and safety of linezolid( Lzd) in the treatment of drug-resistant tuberculosis( DR-TB). Methods From May 2014 to May 2016,10 cases of drug-resistant pulmonary tuberculosis patients treated with linezolid in our hospital were collected and analyzed. The clinical efficacy and safety of the drug use were analyzed. Results The clinical symptoms and symptoms of 10 cases were improved in different degrees. Chest CT was reviewed in 8 patients after treatment,and the lung lesions of the chest were improved and the cavity was narrowed. Among them,4 cases were cavity closed( the shortest time was February and the longest was September).Of the 6 sputum smear positive patients,4 had sputum acid fast staining and negative vaginal rotation,and the vaginal transit time was 30 ~ 210 days. 2 patients had no sputum symptoms after treatment and did not send sputum to test acid fast bacilli smears.Among the 9 patients with positive sputum culture of Mycobacterium tuberculosis in February,there were 3 cases of sputum culture turned negative,the vaginal transit time was 31 ~ 202 days,and 6 patients had no sputum symptoms after treatment,and they did not send sputum for mycobacteria culture. In the course of treatment,1 case of liver damage,1 case of peripheral neuritis,1 case of decreased visual acuity,after withdrawal all symptoms were improved; 1 case of mild thrombocytopenia,1 case of mild nausea and vomiting,and continued treatment was not further aggravated. Conclusion Use of linezolid in the treatment of DR-TB can significantly improve the clinical symptoms of patients,promote the absorption of pulmonary lesions and cavity closure,accelerate the negative conversion of sputum bacteria,and improve the quality of life of patients with DR-TB,with mild adverse reactions which is basically tolerable,and it is of great value in the treatment of drug-resistant tuberculosis. |
Key words: drugresistanttuberculosis linezolid efficacy safety adverseeffects |