摘要
目的 分析贝达喹啉联合利奈唑胺方案对老年耐多药肺结核(MDR-TB)免疫功能及心电图QT间期的影响。方法 选取2021年5月-2022年5月在南京市第二医院接受治疗的93例老年MDR-TB患者,根据治疗方案分为研究组(采用贝达喹啉联合利奈唑胺方案,61例)和对照组(采用利奈唑胺方案,32例)。对两组患者的疗效指标、药物治疗副反应和治疗前、治疗24周末的免疫功能指标进行比较,于治疗前1周内及治疗第4、8、12、16、20、24周对两组患者采用Fridericia公式按心率校正的QT值(QTcF值)进行监测,并记录心电图QT间期延长发生率。结果 研究组患者痰培养结果转阴时间短于对照组(P<0.05),两组患者在治疗24周末免疫功能指标均比治疗前改善(P<0.05),研究组患者治疗前、后免疫功能指标变化的差值高于对照组(P<0.05)。在治疗第4、8、12、16、20周,研究组患者的QTcF值均高于对照组(P<0.05)。研究组QT间期延长发生率高于对照组(P<0.05)。结论 在老年MDR-TB的治疗中,与单用利奈唑胺作为背景抗结核药物方案相比较,采用贝达喹啉联合利奈唑胺作为背景抗结核药物方案,能够加快患者痰培养结果转阴、更加显著地改善患者的免疫功能,但QT间期延长发生率也较高,在临床治疗中应重视对患者心电图表现的监测。
OBJECTIVE To observe the effect of Bedaquiline on immune function and QT interval of the elderly pa-tients with multidrug-resistant tuberculosis(MDR-TB).METHODS A total of 93 elderly patients with MDR-TB who were treated in the Second Hospital of Nanjing,Nanjing University of Traditional Chinese Medicine from May 2021 to May 2022 were enrolled in the study and were divided into the study group with 61 cases and the con-trol group with 32 cases according to the treatment programs.The study group was treated with bedaquiline com-bined with linezolid,and the control group was treated with linezolid.The curative effect indexes and drug-induced adverse reactions were compared between the two groups,the immune function indexes of the two groups of pa-tients were compared before the treatment and after the treatment for 24 weeks.The patients were monitored by QT value(QTcF value)corrected based on heart rate by Fridericia formula before the treatment for 1 week and af-ter the treatment for 4,8,12,16,20 and 24 weeks.The incidence rates of extension of QT interval were recorded.RESULTS The time period of sputum culture turning to be negative was significantly shorter in the study group than in the control group(P<0.05).The immune function indexes of the two groups of patients were improved more significantly after the treatment for 24 weeks than before the treatment(P<0.05).The difference values of the immune function indexes before and after the treatment were significantly higher in the study group than in the control group(P<0.05).The QTcF value of the study group was significantly greater than that of the control group after the treatment for 4,8,12,16 and 20 weeks(P<0.05).The incidence of extension of QT interval of the study group was significantly higher than that of the control group(P<0.05).CONCLUSION As compared with the background antituberculosis drug,linezolid,for treatment of the elderly patients with MDR-TB,bedaq-uiline combined with linezolid may accelerate the sputum culture's turning negative and remarkably improve the immune function,however,the incidence of extension of QT interval is high.It is necessary for the hospital to at-tach great importance to the electrocardiogram of the patients.
作者
刘裔
杨燕
张向荣
LIU Yi;YANG Yan;ZHANG Xiang-rong(The Second Hospital of Nanjing,Nanjing University of Chinese Medicine,Nanjing,Jiangsu 210000,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2024年第5期712-716,共5页
Chinese Journal of Nosocomiology
基金
国家“艾滋病和病毒性肝炎等重大传染病防治”科技重大专项“十三五”项目(2018ZX10725509)。
关键词
贝达喹啉
利奈唑胺
老年
耐多药肺结核
免疫功能
心电图QT间期
Bedaquiline
Linezolid
The elderly
Multidrug-resistant tuberculosis
Immune function
Electrocar-diograrn during QT interval
