| 摘要: |
| 目的观察头孢西丁用于治疗快速生长型非结核分枝杆菌(rapidly growing nontuberculous mycobacteria,RGM)肺病患者的临床疗效。方法回顾性分析经确诊的快速生长型非结核分枝杆菌肺病患者24例资料及治疗情况。观察患者的痰菌阴转率、影像学表现及不良反应。结果24例中耐链霉素23例,耐异烟肼24例,耐利福平21例,耐乙胺丁醇18例,耐阿米卡星20例,耐卷曲霉素23例,耐氧氟沙星22例。治疗2周后患者的临床症状均缓解,10例在治疗半年内痰菌阴转并维持至疗程结束,另14例的痰菌未能阴转。疗程结束时7例病灶吸收,其中4例为显著吸收,3例为吸收;1 7例病灶无变化;4例空洞闭合,3例空洞缩小,17例空洞无改变。治疗痊愈率为41.7%(10/24)。未出现因头孢西丁引起的不良反应。结论快速生长型NTM肺疾病头孢西丁有其治疗价值,在无条件行菌种鉴定和药敏检测的前提下,可联合其他药物组成经验性化疗方案。 |
| 关键词: 分枝杆菌 头孢西丁 治疗 |
| DOI：10.3969/j.issn1008-0392.2013.02.012 |
|
| 基金项目: |
|
| Efficacy of cefoxitin in treatment of rapidly growing nontuberculous mycobacterial pulmonary disease |
| FANG Yong,SHA Wei |
| (Dept. of Tuberculosis, Shanghai Pulmonary Hospital, Tongji University, Shanghai 200433, China) |
| Abstract: |
| Objective To evaluate the therapeutic effect and safety of cefoxitin for rapidly growing nontuberculous mycobacteria （RGM） pulmonary disease. Methods Twenty four patients with RGM pulmonary disease aged 32-76 admitted from January 2007 to December2009 were included in the study. The patients were treated previously and still with sputum positive. A new regimen containing cefoxitin, fluoroquinolone, macrolid, parenteral aminoglycoside and SMZco were adopted. Cefoxitin was used in the first 3 months and lasted for 18 months. Sputum conversion rate, radiology change and side effects were observed before and after the therapy. Results Among the 24 bacterial isolates, 23 strains were resistant to streptomycin,24 to isoniazid,21 to rifampin, 18 to ethambutol, 20 to amikacin,23 to capreomycin and 22 to ofloxacin. After 2 weeks of treatment, the clinical symptoms were improved inall patients. In 10 patients sputum was converted to negative after 6 months of treatment and remained to the end of therapy, while other 14 patients were still sputum positive. Seven patients showed radiological improvement. There were no side effects observed. The total cure rate was 41.7% （10/24）. Conclusion The regimen containing cefoxitin has certain clinical efficacy for RGM nontuborculous mycobacterial pulmonary disease. |
| Key words: mycobacterium cefoxitin therapy |
