地塞米松联合尿激酶治疗结核性胸膜炎的疗效及对胸腔积液IL-6、IL-8和hs-CRP水平的影响  

Effect and Impact of IL-6,IL-8 and hs-CRP in Pleural Effusion in Patients with Tuberculous Pleuritis Treated with Dexamethasone and Urokinase

作　　者：钟红剑[1] 刘腊香[1] 陈文胜[1] 杨澍[2] 

机构地区：[1]广东省深圳市宝安区慢性病防治院,广东深圳518100 [2]广东省深圳市宝安区人民医院

出　　处：《中国医学创新》2016年第18期48-51,共4页Medical Innovation of China

基　　金：深圳市科技计划资助项目(201202189)

摘　　要：目的:探讨地塞米松联合尿激酶治疗结核性胸膜炎的疗效及对胸腔积液IL-6、IL-8和hs-CRP水平的影响。方法:选取2013年1月-2015年1月本院收治的结核性胸膜炎患者64例,按照随机数字表法分为对照组和观察组,各32例。两组均给予常规抗结核治疗和胸腔穿刺抽液,对照组患者给予胸腔内注入尿激酶治疗,而观察组患者则在对照组的基础上胸腔内注入地塞米松。比较两组患者的临床疗效和临床症状的改善情况,检测治疗前和治疗3、7 d后胸腔积液中IL-6、IL-8和hs-CRP水平。结果:观察组治疗的总有效率为87.50%,显著高于对照组的62.50%,差异有统计学意义(P<0.05)。观察组患者胸腔积液消失时间、胸膜厚度显著低于对照组,差异有统计学意义(P<0.05);观察组患者的胸膜粘连发生率为9.38%,显著低于对照组的31.25%,差异有统计学意义(P<0.05)。观察组患者治疗3、7 d后的胸腔积液IL-6、IL-8和hs-CRP的水平显著低于对照组,差异均有统计学意义(P<0.05)。结论:地塞米松联合尿激酶可以显著改善结核性胸膜炎患者的临床症状,且还能降低患者胸腔积液中IL-6、IL-8和hs-CRP的水平,减轻胸膜炎症反应,疗效确切,值得应用于临床。Objective： To discuss the impact of IL-6, IL-8 and hs-CRP in pleural effusion in patients with Tuberculous pleuritis treated with Dexamethasone and Urokinase.Method： A total of 64 patients with tuberculous pleuritis from January 2013 to January 2015 in our hospital were randomly selected and divided into 32 patients of them accepted with conventional oral anti-TB drugs, pleural puncture pumping fluid and intrapleural injection of urokinase were taken as the control group while the other 32 patients of them accepted with intrapleural injection of Dexamethasone were taken as the observation group.The clinical effect and the improvement of clinical symptoms of two group were compared, and the levels of IL-6, IL-8 and hs-CRP before and after 3, 7 d treatment were detected.Result： The total effective rate of the observation group was more than that of the control group, differences between two group had statistical significance （ P〈0.05 ） .The time of hydrothorax disappeared and the pleural thickness of the observation group were more than those of the control group, differences had statistical significance （ P〈0.05 ） .The incidence of pleural adhesions of the observation group was 9.38%, it was lower than that of the control group, difference between two group had statistical significance （ P〈0.05 ） .The levels of IL-6, IL-8 and hs-CRP in pleural effusion after 3, 7 d treatment of the observation group were notably lower than those of the control group, differences between two groups were statistically significant （ P〈0.05 ） .Conclusion： Dexamethasone combined with Urokinase in the treatment of tuberculous pleuritis can improve the chnical symptoms and reduce the levels of IL-6, IL-8 and hs-CRP with exact clinical effect, it is worth of clinical use.

关 键 词：地塞米松 尿激酶 结核性胸膜炎 白细胞介素-6 白细胞介素-8 C-反应蛋白 

分 类 号：R521.7[医药卫生—内科学]