sIL-2R在不同年龄肺结核患者中动态变化及分析  

Dynamic observation and analysis of sIL-2R in patients with active pulmonary tuberculosis in different age groups

作　　者：张晓光[1] 刘会[2] 付洪义[2] 李卫红[2] 王显雷[2] 张焕[2] 

机构地区：[1]河北省胸科医院肾内科,河北石家庄050041 [2]河北省胸科医院结核内科,河北石家庄050041

出　　处：《河北医科大学学报》2016年第9期1010-1013,共4页Journal of Hebei Medical University

基　　金：河北省医学科学研究重点课题(20160494)

摘　　要：目的对不同年龄初治结核菌阳性肺结核患者治疗的不同阶段进行临床观察及游离白细胞介素2受体(soluble interleukin-2receptor,sIL-2R)动态观察,探讨老年肺结核患者治疗过程中病情变化与sIL-2R的关系。方法选择初治结核菌阳性肺结核患者80例,根据年龄分为A组(年龄<60岁,40例)、B组(年龄≥60岁,40例)。A、B组均完成2HRZE/4HR抗结核治疗方案。分别于明确诊断后治疗前、治疗1个月、治疗6个月3个不同时点,观察患者临床症状、痰涂片转阴情况、胸部X线变化情况、血清中sIL-2R情况,比较2组各治疗阶段免疫状态的动态变化。结果治疗1个月时A组临床症状改善有效率、痰抗酸染色转阴率及影像学好转率均高于B组(P<0.05),而2组治疗6个月时差异无统计学意义(P>0.05)。2组在治疗1个月、6个月时sIL-2R呈逐渐下降趋势,但B组在所有时点均高于A组,2组组间、时点间、组间·时点间交互作用差异均有统计学意义(P<0.05)。结论老年继发性肺结核患者治疗过程中sIL-2的恢复晚于中青年患者,这可能影响了老年肺结核患者的治疗效果以及治愈时间。Objective Through the dynamic observation of clinical symptoms and soluble interleukin-2receptor（sIL-2R）in patients with active pulmonary tuberculosis in differet ages and in different stages of the treatment,to investigate the relationship between the disease variety and sIL-2Rin elderly patients.Methods Eighty patients with secondary pulmonary tuberculosis were divided into group A（younger than 60 years old,40cases）and group B（older than 60 years old,40cases）.All patients were received 2HRZE/4HR anti-tuberculosis treatment.In three different time points[before the treatment,1month after the treatment and 6months after the treatment],the changes of the chlinical symptoms,sputum negative conversion rate,the chest X-ray images and the concentions of sIL-2Rwere observed.The dynamic changes of immune status in 2groups were compared and analyzed.Results One month after the treatment,the changes of the clinical symptoms,sputum negative conversion rate,the chest X-ray images of group A were better than those of group B（all P〈0.05）.Six months after the treatment,the difference of effective rates between the two groups had no statistical significance（P〉0.05）.The 2groups in the treatment of 1months and 6months showed a gradual downward trend.But the B group at all time points were higher than the A group.There were significant differences between the 2groups in the group,the time between the time,the interaction between the groups（P〈0.05）.Conclusion The recovery of sIL-2Rlevel in the course of treatment in elderly patients is slower than that of younger patients.These may affect the treatment and the cure time of elderly patients with pulmonary tuberculosis.

关 键 词：结核 肺 受体 白细胞介素2 放射摄影术 

分 类 号：R521[医药卫生—内科学]