胸腺肽联合标准化方案对难治性耐多药肺结核患者血清MMP-9和sTREM-1表达的影响  

Effect of thymosin combined with standardized regimen on serum MMP-9,sTREM-1 expression in patients with refractory multidrug resistant pulmonary tuberculosis

作　　者：陈瑞华[1] 谢婷[1] 贾钦尧 CHEN Ruihua;XIE Ting;JIA Qinyao(Chongqing Three Gorges Center Hospital, Chongqing 404000, China;Institute of medicine, School of pharmacy, North Sichuan Medical College, Nanchong 637000, Sichuan, China)

机构地区：[1]重庆三峡中心医院,重庆404000 [2]川北医学院药学院药物研究所,四川南充637000

出　　处：《西部医学》2020年第7期1067-1070,共4页Medical Journal of West China

基　　金：重庆市卫计委课题(ZY201703067)。

摘　　要：目的观察胸腺肽联合标准方案治疗难治性耐多药肺结核(MDR-TB)的临床疗效及其对患者血清中MMP-9及sTREM-1水平的影响。方法选取2014年1月~2015年10月于重庆三峡中心医院就诊的MDR-TB的患者230例,按照随机数字表法分为对照组和研究组,每组各115例。对照组给予6ZVAmPtoPAS/18 ZVPtoPAS治疗;研究组给予6ZVAmPtoPASCS+胸腺肽/18 ZVPtoPASCS治疗。两组患者在服药期间均加用葡醛内酯片行保肝治疗。观察两组患者的临床疗效,不良反应发生率,测量血清MMP-9及sTREM-1水平。结果研究组治愈率明显高于对照组(P<0.05)。治疗前,两组患者血清中MMP-9及sTREM-1水平比较差异无统计学意义(P>0.05);治疗后,两组患者血清中MMP-9及sTREM-1水平均明显下降,研究组下降程度大于对照组(P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论胸腺肽联合6VZthKP/18VZthP治疗对难治性耐多药肺结核患者的疗效较好,可显著提高患者免疫力,改善患者预后,降低其炎症反应,且无严重不良反应发生,可在临床推广。Objective To observe the clinical efficacy of thymosin combined with standard regimen in the treatment of refractory pulmonary tuberculosis and its effect on serum MMP-9 and sTREM-1 levels.Methods Two hundred and thirty patients with MDR-TB from January 2014 to October 2015 were randomly divided into control group and study group with 115 cases in each group.The control group was treated with 6ZVAmPtoPAS/18 ZVPtoPAS and the study group with 6ZVAmPtoPASCS thymosin/18 ZVPtoPASCS.The clinical efficacy,incidence of adverse reactions and serum MMP-9 and sTREM-1 levels were observed in the two groups.The patients in both groups were treated with gluconolactone tablets during the treatment period.Results The cure rate of the study group was significantly higher than that of the control group(P<0.05).Before treatment,there was no significant difference in serum MMP-9 and sTREM-1 levels between the two groups(P>0.05).After treatment,the serum levels of MMP-9 and sTREM-1 in the two groups were significantly decreased,but the degree of decrease in the study group was significantly higher than that in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Thymosin combined with 6VZthKP/18VZthP has a better effect on patients with refractory pulmonary tuberculosis.It can significantly improve the immunity of patients,improve the prognosis of patients,reduce their inflammatory reaction,and there is no serious adverse reaction,so it is worth popularizing in clinic.

关 键 词：胸腺肽 耐多药肺结核 MMP-9 STREM-1 

分 类 号：R521[医药卫生—内科学]