手术联合抗结核药物治疗空洞性肺结核的疗效及对IL-8、TNF-α等细胞因子的影响  

Effect of surgery combined with anti-tuberculosis drugs on hollow tuberculosis and its effect on IL-8,TNF-αand other cytokines

作　　者：刘永桃 海杰 贺成彦 LIU Yong-tao;HAI Jie;HE Cheng-yan(Department of Surgery,Qinghai Provincial Infectious Disease Specialist Hospital,Xining Qinghai 810000,China)

机构地区：[1]青海省传染病专科医院外科,青海西宁810000

出　　处：《临床和实验医学杂志》2020年第22期2431-2434,共4页Journal of Clinical and Experimental Medicine

基　　金：青海省科技计划项目(编号:2019-ZJ-7084)。

摘　　要：目的探讨手术联合抗结核药物治疗空洞性肺结核的疗效及对白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)等细胞因子的影响。方法前瞻性选取2017年2月到2020年1月青海省传染病专科医院诊治的空洞性肺结核患者116例作为研究对象,根据随机数字表法将其分为观察组与对照组,各58例。对照组给予传统抗结核药物治疗,观察组给予手术联合抗结核药物治疗。治疗6个月后,记录2组患者痰菌阴转率、病灶吸收率及治疗前、治疗后6个月肺功能指标与血清IL-8、TNF-α水平情况。结果治疗后6个月,观察组的痰菌阴转率为98.3%,显著高于对照组的87.9%,差异有统计学意义(P<0.05)。治疗后6个月观察组的病灶吸收率为96.6%,显著高于对照组的82.8%,差异有统计学意义(P<0.05)。观察组治疗前、治疗后6个月FEV1分别为(68.93±2.49)、(98.29±10.48)%,FEV1/FVC比值分别为0.68±0.13、0.82±0.09;对照组治疗前、治疗后6个月FEV1分别为(68.22±3.11)、(78.29±8.38)%,FEV1/FVC比值分别为0.67±0.11、0.73±0.10。治疗后6个月2组的FEV1、FEV1/FVC比值均高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05)。观察组治疗前、治疗后6个月血清IL-8分别为(44.79±2.93)、(7.33±0.33)ng/mL,TNF-α分别为(49.58±3.49)、(8.92±0.18)ng/mL;对照组治疗前、治疗后6个月血清IL-8分别为(45.39±3.59)、(14.50±1.32)ng/mL,TNF-α分别为(49.29±3.22)、(15.09±1.47)ng/mL。2组治疗后6个月的血清IL-8、TNF-α水平均低于治疗前,观察组低于对照组,差异有统计学意义(P<0.05)。结论手术联合抗结核药物治疗空洞性肺结核能抑制IL-8、TNF-α等细胞因子的表达,改善患者的肺功能,提高患者的痰菌阴转率与病灶吸收率,有很好的应用价值。Objective To explore the curative effects of surgery combined with anti-tuberculosis drugs on hollow tuberculosis and its effect on interleukin-8(IL-8),tumor necrosis factor-α(TNF-α)and other cytokines.Methods From February 2017 to January 2020,116 cases of patients with hollow tuberculosis diagnosed and treated in Qinghai Provincial Infectious Disease Specialist Hospital were selected as the research object.The patients were divided into observation group and control group of 58 cases in each groups accorded to the random number table method.The control group were given traditional anti-tuberculosis drug treatment,and the observation group were given surgery combined with anti-tuberculosis drug treatment.The negative conversion rate of sputum bacteria,the absorption rate of the lesion after 6 months of treatment,and the lung function indexes and serum IL-8 and TNF-α levels before and 6 months after treatment were recorded in the two groups.Results The sputum conversion rates in the observation group was 98.3% at 6 months after treatment,which was significantly higher than that in the control group(87.9%),the difference was statistically significant(P<0.05).At 6 months after treatment,the absorption rates of the observation group was 96.6%,which was significantly higher than that of the control group(82.8%),the difference was statistically significant(P<0.05).The FEV1 of the observation group before treatment and 6 months after treatment were(68.93±2.49)% and(98.29±10.48)%,respectively,the ratio of FEV1/FVC was 0.68±0.13,0.82±0.09;the control group before treatment and 6 months after treatment FEV1 was(68.22±3.11)% and(78.29±8.38)%,respectively,and the ratio of FEV1/FVC was 0.67±0.11,0.73±0.10.At 6 months after treatment,the FEV1,FEV1/FVC ratios of the two groups were higher than before treatment,and the observation group were higher than the control group,the differences were statistically significant(P<0.05).In the observation group,serum IL-8 before treatment and 6 months after treatment were(44.79�

关 键 词：空洞性肺结核 手术 抗结核药物 白细胞介素-8 肿瘤坏死因子-α 

分 类 号：R521[医药卫生—内科学]