胸腺五肽联合含利福喷丁化疗方案治疗肺结核的临床疗效及其对细胞免疫功能、炎性因子的影响  

Clinical Effect of Thymopentin Combined with Rifapentine Involved Chemotherapy Regimen on Pulmonary Tuberculosis and the Impact on Cellular Immune Function and Inflammatory Cytokines

作　　者：黄彩转 吴丽群 黄远江 周云 HUANG Cai-zhuan;WU Liqun;HUANG Yuan-jiang;ZHOU Yun(Department of Infectious Diseases,the Second Affiliated Hospital of Hainan Medical University,Haikou 570133,China)

机构地区：[1]海南医学院第二附属医院感染科,海南省海口市570133

出　　处：《实用心脑肺血管病杂志》2018年第9期96-99,共4页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

摘　　要：目的观察胸腺五肽联合含利福喷丁化疗方案治疗肺结核的临床疗效,并探讨其对细胞免疫功能、炎性因子的影响。方法选取2016年1月—2017年9月海南医学院第二附属医院收治的肺结核患者98例,根据随机分组设计分为对照组和观察组,每组49例。对照组患者采用含利福喷丁化疗方案进行治疗,观察组患者在对照组基础上加用胸腺五肽治疗;2个月为1个疗程,两组患者均连续治疗3个疗程。比较两组患者临床疗效、病灶吸收情况,治疗1、3、6个月痰菌转阴率,治疗前后细胞免疫功能指标、炎性因子;并观察两组患者治疗期间不良反应发生情况。结果 (1)观察组患者临床疗效和病灶吸收情况优于对照组(P<0.05)。(2)观察组患者治疗1、3、6个月痰菌转阴率高于对照组(P<0.05)。(3)治疗前两组患者CD_3^+细胞分数、CD_4^+细胞分数、CD_8^+细胞分数及CD_4^+/CD_8^+细胞比值比较,差异无统计学意义(P>0.05);治疗后观察组患者CD_3^+细胞分数、CD_4^+细胞分数、CD_8^+细胞分数及CD_4^+/CD_8^+细胞比值均高于对照组(P<0.05)。(4)两组患者治疗前血清白介素10(IL-10)、干扰素γ(IFN-γ)、转化生长因子β1(TGF-β1)水平比较,差异无统计学意义(P>0.05);观察组患者治疗后血清IL-10、TGF-β1水平低于对照组,血清IFN-γ水平高于对照组(P<0.05)。(5)观察组患者治疗期间不良反应发生率低于对照组(P<0.05)。结论胸腺五肽联合含利福喷丁化疗方案治疗肺结核的临床疗效确切,能有效促进病灶吸收及痰菌转阴,改善细胞免疫功能,降低血清炎性因子水平,且安全性较高。Objective To observe the clinical effect of thymopentin combined with rifapentine involved chemotherapy regimen on pulmonary tuberculosis,to investigate the impact on cellular immune function and inflammatory cytokines.Methods A total of 98 patients with pulmonary tuberculosis were selected in the Second Affiliated Hospital of Hainan Medical University from January 2016 to September 2017,and they were divided into control group and observation group according to randomized blocks design,each of 49 cases.Patients in control group received rifapentine involved chemotherapy regimen,while patients in observation group received extra thymopentin based on that of control group;both groups continuously treated for 3 courses(2 months as a course).Clinical effect,focal absorbing state,sputum negative conversion rate 1 month,3 and 6 months after treatment,index of cellular immune function and inflammatory cytokines were compared between the two groups before and after treatment,and incidence of adverse reactions was observed during treatment.Results (1)Clinical effect and focal absorbing state in observation group were statistically significantly better than those in control group(P<0.05).(2)Sputum negative conversion rate in observation group was statistically significantly higher than that in control group 1 month,3 and 6 months after treatment,respectively(P<0.05).(3)No statistically significant differences of CD3+cell percentage,CD4+cell percentage,CD8+cell percentage or CD4+/CD8+cell ratio was found between the two groups before treatment(P>0.05),while CD3+cell percentage,CD4+cell percentage,CD8+cell percentage and CD4+/CD8+cell ratio in observation group were statistically significantly lower than those in control group after treatment(P<0.05).(4)No statistically significant differences of serum level of IL-10,IFN-γor TGF-β1 was found between the two groups before treatment(P>0.05);after treatment,serum levels of IL-10 and TGF-β1 in observation group were statistically significantly lower than those in control gro

关 键 词：结核 胸腺五肽 利福霉素类 细胞免疫功能 炎性因子 

分 类 号：R52[医药卫生—内科学]