3CMLPa/18MLPa与3SELPaZ/18ELPa对耐多药肺结核患者的免疫功能和氨基酸及细胞因子的影响  

Influence of 3CMLPa/18MLPa and 3SELPaZ/18ELPa on immune function,amino acid and cytokines among multi drug resistant tuberculosis

作　　者：胡耀[1] 蒋海琴[1] 王君[1] 宋锁言 HU Yao;JIANG Hai-qin;WANG Jun;SONG Suo-yan(Department of infectious diseases, General Hospital of Huabei Petroleum Administration, Renqiu Hebei, 062552, Chin)

机构地区：[1]华北石油管理局总医院感染性疾病科,河北任丘062552

出　　处：《职业与健康》2017年第24期3453-3456,F0003,共5页Occupation and Health

摘　　要：目的对比3CMLPa/18MLPa与3SELPa Z/18ELPa对耐多药肺结核患者的免疫功能、氨基酸及细胞因子的影响。方法随机将2014年5月—2016年12月在华北石油管理局总医院感染性疾病科治疗的104例耐多药肺结核分枝杆菌患者分为治疗组和对照组,各52例,治疗组给予3CMLPa/18MLPa(卷曲霉素、莫西沙星、利福喷丁、对氨基水杨酸钠)方案治疗,对照组给予3SELPa Z/18ELPa(链霉素、乙胺丁醇、利福喷丁、对氨基水杨酸钠)方案治疗,治疗6个月后,观察2组的临床疗效,并观察治疗前后的免疫功能、氨基酸及细胞因子的变化。结果 (1)疗效:治疗组的转阴率为69.23%,对照组的转阴率为36.54%,组间差异有统计意义(χ~2=11.153,P<0.05);治疗组的病灶吸收率为80.77%,对照组的病灶吸收率为63.46%,组间差异有统计意义(χ~2=3.873,P<0.05);(2)免疫功能:与治疗前对比,2组治疗后的Ig G、Ig A和Ig M升高(P<0.05),且治疗组升高程度高于对照组,差异有统计学意义(P<0.05);(3)氨基酸:与治疗前对比,2组治疗后的8种氨基酸升高(P<0.05),治疗组治疗后的天冬氨基酸和谷氨基酸明显高于对照组,2组间其余6种氨基酸差异无统计学意义(P>0.05);(4)细胞因子:与治疗前对比,2组治疗后的IL-6、IL-8、IL-17、s E-seletin、s P-seletin、s L-seletin、CD44、SICAM-1及SVCAM-1等细胞因子降低(P<0.05),且治疗组降低程度高于对照组,差异有统计学意义(P<0.05)。结论莫西沙星与卷曲霉素联用治疗耐多药肺结核的效果较好,能有效调节免疫功能和氨基酸水平,降低白介素、可溶性选择素及黏附分子水平,控制病情,有利于患者愈后。[Objective]To compare the influence of 3 CMLPa/18 MLPa and 3 SELPa Z/18 ELPa on immune function,amino acid and cytokines among multi drug resistant tuberculosis.[Methods]A total of 104 cases of multi drug resistant mycobacterium tuberculosis patients treated in department of infectious diseases of General Hospital of Huabei Petroleum Administration from May 2014 to December 2016 were randomly divided into control group and treatment group,52 cases in each group. The treatment group was given the method of 3 CMLPa/18 MLPa（capreomycin,moxifloxacin,rifapentine and sodium aminosalicylate）,and the control group was given the method of 3 SELPa Z/18 ELPa（Streptomycin,ethambutol,rifapentine and sodium aminosalicylate）. After treatment of 6 months,the clinical effects of two groups and the change of immune function,amino acids and cytokines before and after treatment were observed.[Results]（1） Curative effect： negative conversion rate of treatment group was 69.23%,and control group was 36.54%,there was statistically significant difference between two groups（χ~2=11.153,P〈0.05）. The absorption rate of lesion in treatment group was 80.77%,and control group was 63.46%,there was statistically significant difference between two groups（χ~2=3.873,P 0.05）;（2） Immune function： compared with before treatment,Ig G,Ig A and Ig M after treatment in the two groups increased（P〈0.05）,and increased degree of the treatment group was higher than that of the control group,the difference was statistically significant（P〈0.05）;（3）Amino acids： compared with before treatment,8 kinds of amino acids after treatment in the two groups increased（P〈0.05）,the aspartic acid and glutamic acid after treatment in the treatment group were significantly higher than those in the control group,differences of the rest of 6 kinds of amino acid between the two groups were not statistically significance（P 0.05）;（4） Cytokines： compared with before treatment,IL-6,IL-8,IL-17,s E-seletin,s P-seletin,s L-s

关 键 词：肺结核 莫西沙星 卷曲霉素 白介素 可溶性选择素 黏附分子 

分 类 号：R181.35[医药卫生—流行病学]