草分子杆菌注射液对难治性结核性脑膜炎患者外周血中T淋巴细胞亚群改变的影响  

Influence of utilins injection on the changes of peripheral T-lymphocyte subsets in patients with refractory tuberculous meningitis

作　　者：马爱蕊[1] 杨圣俊[2] 王俊霞[1] 闫纪英[1] 周晓映[1] 李洁 李新霞[1] 

机构地区：[1]河北省胸科医院内科,石家庄市050041 [2]河北省人民医院保健科 [3]河北省省直干休一所医务室

出　　处：《河北医药》2009年第11期1305-1307,共3页Hebei Medical Journal

摘　　要：目的探讨草分子杆菌注射液对难治性结核性脑膜炎患者外周血中T淋巴细胞亚群改变的影响。方法选取住院的未经抗结核治疗的难治性结核病脑膜炎患者84例,其中男59例,女25例;年龄15～78岁。随机分为2组,治疗组采用草分子杆菌注射液+HRZE+氟美松+鞘内注药方案;对照组仅用HRZE+氟美松+鞘内注药方案治疗;用药12周。分别统计:显效、有效、无效、总有效率、2组T淋巴细胞亚群治疗前后变化、X线摄胸片显示病变吸收情况、痰菌的转阴情况、脑积液检查以及测定患者外周血T淋巴细胞亚群和NK细胞的变化。结果治疗组总有效率为97.6%,对照组为83.3%,2组比较差异无统计学意义(P>0.05)。但显效率治疗组明显高于对照组(P<0.01)。2组治疗前各项免疫指标比较差异无统计学意义(P>0.05);治疗后治疗组较对照组CD3+、CD4+细胞增加(P<0.01),CD4+/CD8+比值升高(P<0.01),CD8+减低但差异无统计学意义(P>0.05);对照组治疗前后差异无统计学意义(P>0.05)。结论草分子杆菌注射液对难治性结脑患者外周血中T淋巴细胞亚群有免疫调节作用,疗效肯定,不良反应小,是理想的抗结核辅助用药。Objective To investigate the influence of utilins injection on the changes of peripheral blood T-lymphocyte subsets in patients with refractory tuberculous meningitis. Methods 84 patients with refractory tuberculous meningitis, including 25 females and 59 males （age range 15 -78 yr）without antituberculosis treatment, were randomly divided into two groups. The patients in treatment group were treated by utilins ＋ HRZE ＋ dexamethasone intrathecal injection ; the other patients in control group were treated only by HRZE ＋ dexamethasone intrathecal injection, with a treatment course of 12 weeks. The markedly effective rate, effective rate, total effective rate, ineffective rate, the changes of T-lymphocyte subsets before and after treatment, absorption of lesions detected by X-ray, negative transfer state of sputum mycobacterium tuberculosis and the changes of peripheral blood T- lymphocyte subsets and NK cells were observed and compared statistically between two groups. Results The total effective rate in treatment group was 97.6% ,which was 83.3% in control group,however,there was no significant difference between two groups （ P 〉 0.05 ）. The markedly effective rate in treatment group was significantly higher than that of control group（ P 〈0. 01 ）. There were no significant differences in immunological parameters between two groups before treatment （ P 〉 0. 05 ）, but after treatment the CD3^＋ , CD4 cells were obviously increased, as compared with those of control group （ P 〈 0.01 ）, and so did the ratio of CD4^＋ / CD8^＋ （ P 〈 0.01 ）. The CD8^＋ cells were decreased in treatment group, however, there was no significant difference between two groups （ P 〉 0.05 ）, and so did the difference in control group before and after treatment （ P 〉 0.05 ）. Conclusion Utilins injection has immunoregulating effect on the peripheral blood T-lymphocyte subsets in patients with refractory tuberculous meningitis, with the obvious increase of CD3^＋ , CD4^＋ cells, decrease

关 键 词：草分子杆菌注射液 难治性结核性脑膜炎 T淋巴细胞亚群 辅助治疗 

分 类 号：R529.3[医药卫生—内科学]