生物反应调节剂对结核性腹膜炎合并肠梗阻外科治疗的疗效观察  

Observation of curative effect of biological response modifier on tuberculous peritonitis patients complicated with intestinal obstruction received surgical treatment

作　　者：苏宏伟[1] 齐海亮[1] 张金文[1] 王鹏[1] 李明珠[1] 

机构地区：[1]河北省胸科医院胸二科,河北石家庄050041

出　　处：《临床肺科杂志》2015年第11期1966-1968,共3页Journal of Clinical Pulmonary Medicine

摘　　要：目的观察CD_3^+、CD_4^+、CD_8^+T-细胞亚群的表达水平在结核性腹膜炎合并肠梗阻患者外科治疗中的作用。方法选择行部分肠切除一期吻合术的86例结核性腹膜炎合并肠梗阻的患者,将应用免疫反应调节剂的49例病人做为治疗组,将未使用免疫反应调节剂的的37例病人做为对照组,治疗组术前术后给予"RHZE+左氧氟沙星+营养支持"加用生物反应调节剂治疗;对照组术前术后给予"RHZE+左氧氟沙星+营养支持"治疗。观察两组治疗前后的表达情况及术后肠瘘发生率情况。结果 T细胞亚群测定结果显示治疗组治疗前后CD_3^+、CD_4^+、CD_8^+的变化与对照组治疗前后的变化在统计学上差异具有显著性(P<0.05);治疗组49例术后发生肠瘘2例,经换药治疗后1周好转;对照组37例发生肠瘘7例,经加强营养支持及换药治疗后6例好转,1例死亡。两组差异具有显著性(P<0.05)。结论通过外源性生物反应调节剂,调节机体T淋巴细胞亚群CD_3^+、CD_4^+、CD_8^+的表达水平能提高机体免疫力,能显著降低术后因感染诱发肠瘘的几率,故调节剂可作为结核性腹膜炎合并肠梗阻外科治疗的免疫辅助治疗方法。Objective To observe the expression of CD3＋, CD4＋ and CD8＋ T- cells in tuberculous peritoni-tis patients complicated with intestinal obstruction. Methods 86 tuberculous peritonitis patients complicated with in-testinal obstruction who were given partial intestinal resection were selected, and 49 of them were given immune re-sponse regulator as the treatment group and the rest as the control group. The treatment group was given ＆quot;RHZE＋levofloxacin＋nutrition support＆quot; therapy plus immune response regulator preoperatively. The control group was given＆quot;RHZE ＋ levofloxacin ＋ nutrition support＆quot; only. The expression of CD3＋, CD4＋ and CD8＋ T cells was detected and the incidence of postoperative intestinal fistula was analyzed. Results The expression of CD3＋, CD4＋ and CD8＋showed significant difference before and after the treatment between the two groups （P〈0. 05）. There were 2 cases of intestinal fistula occurred in the treatment group, who turned better 1 week after re-treatment. There were 7 cases of intestinal fistula in the control group, and 6 of them became better after re-treatment and 1 case died. Conclusion Body immunity can be improved by exogenous bioreactor regulator to regulate the body＇s T lymphocyte subsets ex-pression, which also can significantly reduce the postoperative infection induced intestinal fistula. Therefore, the reg-ulation of the expression of CD3＋, CD4＋ and CD8＋ can be used as an immune assist therapy for tuberculous peritonitis patients complicated with intestinal obstruction received surgical treatment.

关 键 词：结核性腹膜炎 肠梗阻 肠瘘 CD3+、 CD4+、 CD8+T细胞亚群 

分 类 号：R656[医药卫生—外科学]