Clinical efficacy and computed tomography diagnostic value of bedaquiline-containing regimens in the treatment of drug-resistant pulmonary tuberculosis

iLABMED Pub Date : 2024-08-27 DOI:10.1002/ila2.57

Saiduo Liu, Xinchun Ye, Fang Cheng, Kaijia Wu, Jiandan Yu, Hongye Ning, Jichan Shi, Hongzhou Lu, Wei Chen

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Abstract

Objective

This study investigated the clinical efficacy of bedaquiline-containing regimens in the treatment of drug-resistant pulmonary tuberculosis and the diagnostic value of computed tomography (CT).

Methods

We retrospectively analyzed the clinical diagnosis, treatment, and CT imaging data of patients with drug-resistant pulmonary tuberculosis treated in Wenzhou Central Hospital from 1 January to 31 December 2022. According to whether the treatment regimen contained bedaquiline, the patients were divided into an observation group (bedaquiline tablets + background regimen) and a control group (background regimen). The clinical efficacy and pulmonary CT changes before and after treatment were analyzed in both groups.

Results

After 24 weeks of treatment, there was no statistically significant difference in the white blood cell count or concentrations of hemoglobin, alanine aminotransferase, serum albumin, or creatinine between the two groups (t = 0.71, 0.93, 0.05, 0.18, and 0.08, respectively; p > 0.05). After 4, 8, and 12 weeks of treatment, there was no statistically significant difference in the sputum culture-negative conversion rate between the two groups (χ² = 2.67, 0.48, and 1.82, respectively; p > 0.05). At 24 weeks of treatment, the sputum culture-negative conversion rate in the observation group reached 100%, which was significantly higher than that in the control group (χ² = 3.97, p < 0.05). The effective absorption rates on chest imaging in the two groups of patients at 12 weeks were 83.33% and 57.89%, respectively. At 24 weeks of treatment, the effective absorption rates were 88.00% and 65.85% in the two groups, with a statistically significant difference (χ² = 3.98; p < 0.05). There were significant differences in cavity absorption at 24 weeks (χ² = 4.33, p < 0.05) and 48 weeks after treatment (χ² = 10.63, p < 0.05).

Conclusion

The addition of bedaquiline to the background regimen improved the sputum culture-negative conversion rate and chest imaging effective rate. Patients achieved good results at the end of the 24-week treatment period.

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含贝达喹啉方案治疗耐药肺结核的临床疗效和计算机断层扫描诊断价值

目的本研究探讨了含贝达喹啉方案治疗耐药肺结核的临床疗效及计算机断层扫描（CT）的诊断价值。方法回顾性分析温州市中心医院2022年1月1日至12月31日收治的耐药肺结核患者的临床诊断、治疗和CT影像学资料。根据治疗方案中是否含有贝达喹啉，将患者分为观察组（贝达喹啉片+背景方案）和对照组（背景方案）。分析两组患者治疗前后的临床疗效和肺部 CT 变化。结果治疗 24 周后，两组的白细胞计数和血红蛋白、丙氨酸氨基转移酶、血清白蛋白或肌酐浓度差异无统计学意义（t = 0.71、0.93、0.05、0.18 和 0.08，分别为 p >0.05）。治疗 4 周、8 周和 12 周后，两组痰培养阴转率差异无统计学意义（χ2 分别为 2.67、0.48 和 1.82；P >；0.05）。治疗24周时，观察组痰培养阴转率达到100%，明显高于对照组（χ2 = 3.97，P <0.05）。治疗 12 周时，两组患者胸部造影的有效吸收率分别为 83.33% 和 57.89%。治疗 24 周时，两组患者的有效吸收率分别为 88.00% 和 65.85%，差异有统计学意义（χ2 = 3.98; p <0.05）。治疗后 24 周（χ2 = 4.33，p < 0.05）和 48 周（χ2 = 10.63，p < 0.05）的空穴吸收率存在明显差异。结论在背景方案中加入贝达喹啉可提高痰培养阴转率和胸部影像学有效率。在 24 周的治疗期结束时，患者取得了良好的疗效。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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