Efficacy of glutathione combined with a bedaquiline-containing regimen in the treatment of multidrug-resistant tuberculosis patients
ZHANG Panpan
CHENG Qianqian
ZHANG Mingfeng
CHEN Yingying
YANG Liu
Abstract：Objective To investigate the efficacy and impact on liver function of reduced glutathione combined with a bedaquiline-containing regimen in patients with multidrug-resistant pulmonary tuberculosis.Methods A prospective controlled study design was adopted.A total of 60 patients with multidrug-resistant pulmonary tuberculosis admitted to the Third Hospital of Cangzhou from January 2023 to December 2023 were enrolled and randomly divided into the control group and the observation group(n=30 each)using a computer-generated random number table.The control group received bedaquiline-containing regimen,while the observation group received reduced glutathione combined with bedaquiline-containing regimen.Clinical efficacy(sputum culture conversion,lesion absorption,and cavity reduction rates),liver function parameters(alanine aminotransferase(ALT),as-partate aminotransferase(AST),total bilirubin,alkaline phosphatase(ALP)),drug-induced liver injury(DILI)grade,inflammatory markers(C-reactive protein(CRP),interferon-gamma(IFN-γ)),and pulmonary function were compared between the two groups.Results After treatment,there were no statistically significant differences in sputum culture conversion rate(86.67%(26/30)vs 93.33%(28/30)),lesion absorption rate(76.67%(23/30)vs 83.33%(25/30)),and cavity reduction rate(76.67%(23/30)vs 80.00%(24/30))between the control group and observation group(χ2=0.185,0.417,0.098,all P>0.05).After treatment,the levels of ALT,AST,total bilirubin,and ALP increased in both groups,and these indicators were significantly lower in the observation group((155.65±12.77)U/L,(123.49±12.27)U/L,(23.18±2.15)μmol/L,(78.16±9.32)U/L)compared to the control group((171.48±14.93)U/L,(139.61±13.52)U/L,(27.78±3.49)μmol/L,(86.92±10.27)U/L)(t=4.413,4.836,6.147,3.460,all P<0.05).Grade 2(moderate)DILI was predominant in both groups(the control group:86.67%(26/30),the observation group:83.33%(25/30)),with no statistically sig-nificant difference in DILI grade distribution between the two groups(Z=1.669,P>0.05).After treatment,CRP levels decreased and IFN-γ levels increased in both groups,with the observation group showing a lower CRP((10.13±1.77)mg/L vs(13.25±2.04)mg/L)and a higher IFN-γ((38.64±5.38)ng/mL vs(32.57±5.12)ng/mL)compared to the control group(t=6.327,4.477,both P<0.05).After treatment,pulmonary function(one-second forced expiratory volume(FEV1)and FEV1/forced vital capacity ratio)improved in both groups,with the observation group showing higher values((2.46±0.42)L,(81.21±9.64)%)compared to the control group((1.95±0.37)L,(70.59±9.01)%)(t=4.991,4.408,both P<0.05).Conclusion The combination of reduced glutathione and the bedaquiline-containing regimen for the treatment of multidrug-resistant pulmonary tuberculosis not only maintains clinical efficacy comparable to monother-apy with the betacarbazone-containing regimen,but also significantly improves patients'liver function parameters,reduces the severi-ty of liver injury,alleviates inflammatory responses,and promotes the recovery of pulmonary function.
Keywords：multidrug-resistant pulmonary tuberculosisreduced glutathionebedaquilineefficacyliver function
Publication Date：2026-02-25
Online Publishing Date：2026-03-16(First online date of this platform, not the publication date of the document)
Pages：5( 237-241 )