莫西沙星联合用药方案对耐多药肺结核患者血清游离氨基酸和免疫功能的影响

目的:探讨莫西沙星联合用药方案对耐多药肺结核(MDR-TB)患者血清游离氨基酸和免疫功能的影响。方法:选取2015年9月到2018年1月期间我院收治的90例MDR-TB患者,根据乱数表法将患者分为研究组(n=45)、对照组(n=45),其中对照组给予左氧氟沙星联合常规化疗治疗,研究组则给予莫西沙星联合常规化疗治疗,比较两组临床疗效、痰菌转阴率、病灶吸收率、空洞闭合率、血清游离氨基酸和免疫功能,记录两组治疗期间不良反应情况。结果:研究组治疗18个月后的临床总有效率为71.11%(32/45),高于对照组的46.67%(21/45)(P0.05)。研究组治疗18个月后痰菌转阴率、病灶吸收率、空洞闭合率均较对照组高(P0.05)。两组患者治疗18个月后CD4+、免疫球蛋白A(Ig A)、免疫球蛋白G(Ig G)均升高,CD8+降低(P0.05),研究组治疗18个月后CD4+、Ig A、Ig G高于对照组,而CD8+低于对照组(P0.05)。两组治疗18个月后缬氨酸、谷氨酸均升高,且研究组高于对照组(P0.05)。两组患者总不良反应发生率比较无明显差异(P0.05)。结论:莫西沙星联合常规化疗治疗MDR-TB的疗效确切,可有效改善患者血清游离氨基酸水平,提高机体免疫功能,同时不增加不良反应发生率。

Effect of Moxifloxacin Combination Regimen on Serum Free Amino Acid and Immune Function in Patients with Multidrug-resistant Tuberculosis

ABSTRACT Objective: To investigate the effect of moxifloxacin combination regimen on serum free amino acid and immune function in patients with multidrug-resistant tuberculosis (MDR-TB). Methods: 90 patients with MDR-TB who were admitted to our hospital from September 2015 to January 2018 were selected, and they were divided into study group (n=45) and control group (n=45) according to random number table method. The control group was given levofloxacin combined with conventional chemotherapy, while the study group was given moxifloxacin combined with conventional chemotherapy. The clinical efficacy, sputum negative conversion rate, lesion absorption rate, cavity closure rate, serum free amino acid and immune function between two groups were compared. Adverse reactions during treatment were recorded. Results: The total effective rate of the study group at 18 months after treatment was 71.11%(32/45), which was higher than 46.67%(21/45) of the control group (P<0.05). 18 months after treatment, sputum negative conversion rate, lesion absorption rate and cavity closure rate of the study group were higher than those of the control group (P<0.05). 18 months after treatment, the CD4⁺, immunoglobulin A (IgA) and immunoglobulin G (IgG) increased, and CD8⁺ decreased of both groups (P<0.05). 18 months after treatment, the CD4⁺, IgA and IgG of the study group were higher than those of the control group, while CD8⁺ was lower than those of the control group (P<0.05). 18 months after treatment, the valine and glutamic acid increased of both groups, and those of the study group were higher than of the control group (P<0.05). There was no significant difference in the incidence of total adverse reactions of both groups (P>0.05). Conclusion: Moxifloxacin combined with conventional chemotherapy has a definite effect on MDR-TB, which can effectively improve the serum free amino acid level of patients, improve the immune function of the body, and it do not increase the incidence of adverse reactions.