贝达喹啉对耐多药肺结核患者免疫功能及细胞因子的影响  

Effect of bedaquine on immune function and cytokines in patients with multidrug-resistant pulmonary tuberculosis

作　　者：班立芳 马峥[2] 孔庆飞[1] 陈永芳[2] 夏玉朝[3] 李峰[1] 常瑞霞[1] 李小龙[4] BAN Lifang;MA Zheng;KONG Qingfei;CHEN Yongfang;XIA Yuchao;LI Feng;CHANG Ruixia;LI Xiaolong(Department of Clinical Laboratory,the Six People′s Hospital of Zhengzhou/Henan Provincial Infectious Diseases Hospital,Zhengzhou,Henan 450015,China;Department of Tuberculosis,the Six People′s Hospital of Zhengzhou/Henan Provincial Infectious Diseases Hospital,Zhengzhou,Henan 450015,China;Department of Pharmacy,the Six People′s Hospital of Zhengzhou/Henan Provincial Infectious Diseases Hospital,Zhengzhou,Henan 450015,China;Department of Infection Management,the Six People′s Hospital of Zhengzhou/Henan Provincial Infectious Diseases Hospital,Zhengzhou,Henan 450015,China)

机构地区：[1]郑州市第六人民医院/河南省传染病医院检验科,河南郑州450015 [2]郑州市第六人民医院/河南省传染病医院结核病科,河南郑州450015 [3]郑州市第六人民医院/河南省传染病医院药学部,河南郑州450015 [4]郑州市第六人民医院/河南省传染病医院感染管理科,河南郑州450015

出　　处：《检验医学与临床》2020年第16期2292-2294,共3页Laboratory Medicine and Clinic

基　　金：河南省医学科技攻关计划项目(2018020850、201702328)。

摘　　要：目的探讨贝达喹啉对耐多药肺结核的免疫功能及细胞因子的影响。方法选取105例耐多药肺结核患者作为研究对象,随机分为观察组(53例)和对照组(52例),两组患者均采用常规耐多药肺结核治疗方案,观察组患者在此基础上加用贝达喹啉,均连续治疗24周。两组患者治疗前、后痰菌转阴率、免疫功能指标及细胞因子水平进行比较。结果观察组患者治疗后痰菌转阴率[50(94.34%)]高于对照组[42(80.77%)],差异有统计学意义(P<0.05);观察组患者治疗后血清免疫功能指标免疫球蛋白(Ig)A、IgG和IgM水平高于对照组,差异有统计学意义(P<0.05);观察组患者治疗后血清细胞因子肿瘤坏死因子-α、C-反应蛋白、γ干扰素、白细胞介素-6和降钙素原水平低于对照组,差异有统计学意义(P<0.05)。结论贝达喹啉可改善耐多药肺结核患者免疫功能和细胞因子水平,提高痰菌转阴率,可有效指导耐多药肺结核的临床用药治疗的效果。Objective To explore the effect of bedaquine on immune function and cytokines in patients with multidrug-resistant pulmonary tuberculosis.Methods 105 patients with multidrug-resistant pulmonary tuberculosis were selected as subjects,and randomly divided into observation group(53 cases)and control group(52 cases).The patients in both groups were treated with conventional treatment.The patients in the observation group were given bedaquine on this basis.The two groups were treated continuously for 24 weeks.The sputum negative rate,immune function index and cytokines level of the two groups were compared before and after treatment.Results The sputum negative rate[50(94.34%)]in the observation group was higher than that in the control group[42(80.77%)],the difference was statistically significant(P<0.05).The levels of immunoglobulin(Ig)A,IgG and IgM in the observation group were significantly higher than those in the control group,the difference was statistically significant(P<0.05).After treatment,the serum levels of tumor necrosis factor-α,C-reactive protein,interferon-γ,interleukin-6 and procalcitonin in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).Conclusion Bedaquine could improve the immune function and cytokines in patients with multidrug-resistant pulmonary tuberculosis,enhance the sputum negative rate,and effectively guide the clinical treatment of multidrug-resistant tuberculosis.

关 键 词：耐多药肺结核 贝达喹啉 免疫功能 细胞因子 

分 类 号：R521[医药卫生—内科学]