关键词: 结核,肺/药物疗法, 抗感染药,氟喹诺酮, 抗药性,多种

Abstract: Objective To compare and evaluate the clinical application value of four fluoroquinolones: Ciprofloxacin（C）, Ofloxacin（O）, Levofloxacin（V）, and Sparfloxacin（S_P）.Methods 168 retreatment multi-drug-resistant pulmonary tuberculosis cases that confirmed bacterilogically were divided into four research groups and one control group randomly.The regimen of the control group was 3HRZEAK/5HL₂ZE/4HL₁E, while C,O,V AND S_P was added to the regimen used in the control group four research groups respectively in the first eight months. The Results of bacteriological examination,X-ray examination and side effects of the drugs were collected and compared at the end of full treatment courses and two years’follow-up.Results The sputum negative conversion rates at the end of full treatment course used C, O, V and S_P were respectively 70.0%, 73.3%, 80.7% and 93.5%.It was 40.0% in the control group. Effect rates of X-ray-examined focus turned out were 86.6%, 86.6%, 90.8% and 90.3%.It was in the control group. Closure rates of cavities were respectively 53.3%, 58.8%, 85.7% and 70.6%, compared to 18.8% of the control group. There were statistical differences on the above 3 indicators of the research groups and the control group （ P <0.01）. Among the research groups the sputum negative conversion rate of bacteria rate of group O was similar to that of group C （ P > 0.05 ）. Group V resembled group S_P （ P >0.05 ）. Group V and group SP dwarfed group C and group O respectively （ P <0.05 ）. There were no significant difference on the effect rates of X-ray examined focus or closure rates of cavities in the research groups （ P >0.05 ）. No adverse reactions were reported during the treatment course. Recurrence rate of sputum bacteria of the five groups after two years’follow-up was 5.0%, 5.0%, 4.0%, and 3.8% respectively and it was 35.7% in the control group. There were significant differences of these indicators of the research groups and the control group （ P <0.05）. There were 1 case in each of the four research groups and 5 cases in the control group whose X-ray focus deteriorated and 6 cases in the control group whose cavities deteriorated. There were significant differences of X-ray Results of all the reaearch groups and the control group （ P <0.05 ）.Conclusion Ciprofloxacin, ofloxacin, levofloxacin and sparfloxacin were respectively added retreatment multi-drug-resistant pulmonary tuberculosis cases and were observered that patients’ the sputum negative conversion rates were increased and recurrent rates were reduced.The Results showed that those drugs were safe and reliable for curing pulmonary tuberculosis cases. Levofloxacin or sparfloxacin is preferable to ciprofloxacin or ofloxacin.

Key words: Tuberculosis,pulmonary/drug therapy, Anti-infective agents,fluoroquinolone, Drug resistance,multiple