阿米卡星联合常规抗痨药物对进展期肺结核患者免疫功能及血清PCT、CRP、IL-6、TNF-α表达的影响  

Effects of amikacin combined with conventional anti-tuberculosis drugs on immune function and expression of serum PCT, CRP, IL-6 and TNF-α in patients with advanced pulmonary tuberculosis

作　　者：李新刚 LI Xin’gang(Department of Second Tuberculosis, Jiamusi Cancer Tuberculosis Hospital in Heilongjiang Province, Jiamusi 154002, China)

机构地区：[1]黑龙江省佳木斯市肿瘤结核医院结核二内科

出　　处：《中国现代医生》2019年第20期27-29,33,共4页China Modern Doctor

摘　　要：目的探讨阿米卡星联合常规抗痨药物对进展期肺结核患者免疫功能及血清PCT、CRP、IL-6、TNF-α表达的影响。方法选取我院2017年1月~2018年1月收治的94例肺结核患者为研究对象,采用随机数字表法将其分为对照组和观察组,各47例。对照组采用常规四联抗结核方案治疗,观察组加用阿米卡星治疗。比较两组痰涂片转阴率、炎症因子水平及免疫功能。结果观察组3、6、9个月痰涂片阴转率为44.68%、61.70%、93.61%,均明显高于对照组的23.40%、40.42%、74.46%(P<0.05);治疗后,观察组PCT、CRP、IL-6、TNF-α水平均低于对照组(P<0.05),观察组CD8^+水平低于对照组,CD3^+、CD4^+、CD4^+/CD8^+水平高于对照组(P<0.05)。结论阿米卡星联合常规抗痨药物治疗可提高进展期肺结核患者痰菌转阴率,增强免疫功能,减轻炎症反应。Objective To investigate the effects of amikacin combined with conventional anti-tuberculosis drugs on immune function and expression of serum PCT, CRP, IL-6 and TNF-α in patients with advanced pulmonary tuberculosis.Methods A total of 94 patients with pulmonary tuberculosis admitted to our hospital from January 2017 to January 2018 were enrolled in the study. They were divided into control group and observation group by random number table method, with 47 cases in each group. The control group was treated with conventional quadruple anti-tuberculosis regimen, and the observation group was added with amikacin. The sputum smear negative conversion rate, inflammatory factor level and immune function were compared between the two groups. Results The sputum smear negative conversion rates were 44.68%, 61.70%, and 93.61% in the observation group at 3, 6, and 9 months, which were significantly higher than those in the control group(23.40%, 40.42%, 74.46%),(P<0.05). After treatment, the PCT, CRP, IL-6 and TNF-α levels in the observation group were lower than those in the control group(P<0.05). The CD8^+ level in the observation group was lower than that in the control group, and the CD3^+, CD4^+, CD4^+/CD8^+ levels were higher than those of the control group(P<0.05). Conclusion Amikacin combined with conventional anti-tuberculosis drugs can improve sputum bacteria negative conversion rate, improve immune function and reduce inflammation in patients with advanced tuberculosis.

关 键 词：阿米卡星 进展期肺结核 免疫功能 炎症反应 

分 类 号：R521[医药卫生—内科学]