中国药物与临床2024,Vol.24Issue(1) :24-28.DOI:10.11655/zgywylc2024.01.005

含贝达喹啉氯法齐明方案治疗耐多药肺结核的临床疗效

Clinical efficacy of bedaquiline and clofazimine-containing treatment of multi-drug resistant pulmonary tuberculosis

洪爱玲 赵丰权 蔡玉伟 李君桦
中国药物与临床2024,Vol.24Issue(1) :24-28.DOI:10.11655/zgywylc2024.01.005

含贝达喹啉氯法齐明方案治疗耐多药肺结核的临床疗效

Clinical efficacy of bedaquiline and clofazimine-containing treatment of multi-drug resistant pulmonary tuberculosis

洪爱玲 1赵丰权 1蔡玉伟 1李君桦1
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作者信息

  • 1. 温州市中心医院 温州市第六人民医院结核病3科,浙江温州 325099
  • 折叠

摘要

目的 分析在含贝达喹啉、氯法齐明治疗方案对耐多药肺结核患者的临床疗效.方法 收集2020年9月至2022年7月温州市第六人民医院耐多药肺结核患者60例分为观察组和对照组,各30例.对照组使用利奈唑胺、左氧氟沙星(或莫西沙星)、环丝氨酸、吡嗪酰胺、丙硫异烟胺,观察组使用贝达喹啉、氯法齐明替代吡嗪酰胺、丙硫异烟胺,其他药物相同,2组均观察24周.根据治疗24周痰培养转阴率和肺部病灶吸收率评估有效性,分析心电图QTc变化、肝功能异常、胃肠道反应等评估用药安全性.结果 观察组治疗8周、12周痰菌转阴率分别为79%(22/28)和21%(6/28),高于对照组的62%(18/29)和17%(5/29)(P<0.05);观察组短期有效率93%(26/28)高于对照组76%(22/29)(P<0.05).在安全性上,观察组2例因QTc间期延长,退出治疗组;对照组中1例因肝衰竭退出,2组的不良反应比较差异无统计学意义(P>0.05).结论 含贝达喹啉、氯法齐明方案治疗耐多药肺结核短期临床疗效及耐受性均较好.

Abstract

Objective To retrospectively analyse the clinical efficacy of patients with multidrug-resistant tuberculosis on bedaquiline and clofazimine-containing treatment regimens.Methods A total of 60 cases of mul-tidrug-resistant tuberculosis patients in the Sixth People's Hospital of Wenzhou City were collected from September 2020 to July 2022.They were divided into an observation group and a control group,with 30 patiets in each group.The patients in control group were treated with linezolid,levofloxacin(or moxifloxacin),cycloserine,pyrazi-namide,and propionate isoniazide,while the patients in observation group were treated with betaquiline,clofaz-imine instead of pyrazinamide and propionate isoniazide.The other drugs used by the two groups were the same,and the treatment duration for both groups was 24 weeks,with the total treatment corse not yet completed.The ef-fectiveness was evaluated based on the sputum culture conversion rate and lung lesion absorption rate after 24 weeks of treatment.The safety was assessed by analyzing changes in electrocardiogram QTc,liver function abnor-malities,and gastrointestinal reactions.Results The sputum bacterial conversion rates in the observation group were 79%(22/28)and 21%(6/28)at 8 and 12 weeks of treatment,respectively,which were higher than the control group's 62%(18/29)and 17%(5/29)(P<0.05).The short-term effectiveness rate of the observation group was 93%(26/28),which was higher than the control group's 76%(22/29)(P<0.05).In terms of safety,two patients in the observation group withdrew from the treatment group due to significant prolongation of QTc interval;one patient in the control group withdrew due to hepatic failure.There was no statistically significant difference in adverse reac-tions between the two groups(P>0.05).Conclusion The short-term clinical efficacy and tolerability of the be-daquiline and clofazimine-containing regimen for the treatment of multidrug-resistant tuberculosis are better.

关键词

抗药性,多药/贝达喹啉/氯法齐明/药物评价/抗结核药物

Key words

Drug resistance,multiple/Bedaquiline/Clofazimine/Drug evaluation/Anti-tuberculosis drugs

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出版年

2024
中国药物与临床
中国医院协会

中国药物与临床

影响因子:0.846
ISSN:1671-2560
参考文献量20
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