胸腺五肽辅助治疗耐药性肺结核病患者疗效及其对免疫功能和血清炎性因子的影响  

Effect of thymopentin on adjuvant treatment of drug resistant tuberculosis patients and its effect on immune function and inflammatory factors

作　　者：邹鹏[1] 陈丽 朱庭菊 彭胜利[1] 潘惠玲[1] 夏明 

机构地区：[1]武汉市医疗救治中心呼吸内科,430023 [2]武汉市新洲区人民医院呼吸内科,430023

出　　处：《疑难病杂志》2017年第12期1217-1220,共4页Chinese Journal of Difficult and Complicated Cases

摘　　要：目的观察胸腺五肽联合常规抗结核药物治疗耐药性结核病(MDR-TB)患者的疗效及其对免疫功能和血清炎性因子的影响。方法回顾性分析2014年1月—2016年1月武汉市医疗救治中心呼吸内科收治的MDRTB患者156例的临床资料。按照临床治疗方案的不同分为对照组(67例)与观察组(89例)。对照组采用IHRZE/4HR标准化疗方案,观察组在此基础上联合胸腺五肽注射液,治疗8周后对比2组患者肺功能、免疫功能、炎性因子水平、痰菌转阴率、病灶吸收好转率及不良反应。结果治疗8周后,观察组FEV_1%预计值及FEV_1/FVC均明显高于对照组(t=6.123、6.456,P=0.023、0.017);T淋巴细胞CD3^+、CD4^+、CD4^+/CD8^+水平均显著高于治疗前和对照组(P均<0.05),炎性因子IL-10水平显著低于对照组,而IFN-γ水平显著高于对照组(P均<0.05)。痰菌转阴率、病灶吸收好转率较对照组均升高(88.76%vs.70.15%,χ~2=5.467,P=0.014;93.26%vs.77.61%,χ~2=6.112,P=0.003);不良反应发生率观察组为5.62%,对照组为11.94%,2组比较差异有统计学意义(χ~2=6.112,P=0.017)。结论胸腺五肽可以提高MDR-TB患者治疗效果,提高免疫功能,促进病灶吸收,具有较高的安全性。Objective To observe the efficacy of thymopentin combined with conventional anti-tuberculosis drugs in the treatment of drug resistant tuberculosis（MDR-BT）patients.Methods We retrospectively analyzed the clinical data of 156 MDR-BT patients admitted to the Department of Respiratory Medicine, Wuhan Medical Treatment Center, from January 2014 to January 2016.According to the different clinical treatment programs,patients were divided into control group（67 ca-ses）and observation group（89 cases）.Lung function, sputum negative rate, rate of improvement of lesion, immune func-tion,inflammatory factor and adverse reactions in the two groups were observed and compared.Results The FEV1%predic-ted and FEV1/FVC were significantly higher in the observation group than in the control group after 8 weeks of treatment [（80.53 ＆#177;3.17）vs.（71.24 ＆#177;3.55）,t=6.123,P=0.023;（89.78 ＆#177;4.26）vs.（81.34 ＆#177;4.84）,t=6.456,P=0.017]. The rate of conversion of sputum and the rate of improvement of lesion in the observation group were higher than those in the control group（88.76%vs.70.15%,χ2=5.467,P=0.014,93.26% vs.77.61%,χ2=6.112,P=0.003）.The levels of CD3 ＋,CD4 ＋,CD4 ＋/CD8 ＋in T lymphocytes were significantly higher in the observation group than those in the control group before and after treatment[（71.56 ＆#177;6.07）vs.（60.11 ＆#177;5.32）,t=4.998,P=0.032;（39.16 ＆#177;5.13）vs.（26.92 ＆#177; 3.79）,t=5.470,P=0.021;（39.16 ＆#177;5.13）vs.（26.92 ＆#177;3.79）,t=5.470,P=0.021].The level of IL-10 in the observa-tion group was significantly lower than that in control group[（0.40 ＆#177;0.09）pg/ml vs.（0.58 ＆#177;0.08）pg/ml,t=5.323,P=0.009],while the level of IFNγwas significantly higher than that in control group[（7.44 ＆#177;0.32）pg/ml vs.（6.24 ＆#177;0.37） pg/ml,t=4.011,P=0.021].The incidence of adverse reactions in the control group was 11.94%.The incidence of adverse reactions in the observation group was 5.62%,the difference was statis

关 键 词：胸腺五肽 耐药性结核病 细胞免疫 肺功能 炎性因子 

分 类 号：R521[医药卫生—内科学]