草分枝杆菌辅助治疗对耐多药肺结核患者临床疗效、免疫功能的影响  

Effect of adjuvant treatment of Mycobacterium phlei on clinical efficacy and immune function in patients with multidrug-resistant tuberculosis

作　　者：王起 黄移生 陈红梅 罗丹霖 WANG Qi;HUANG Yi-sheng;CHEN Hong-mei;LUO Dan-lin(Department 1 of Tuberculosis,Hunan Chest Hospital,Changsha,Hunan 410013,China;Department of Drug Resistant Tuberculosis,Hunan Chest Hospital,Changsha,Hunan 410013,China)

机构地区：[1]湖南省胸科医院结核内一科,湖南长沙410013 [2]湖南省胸科医院耐药结核科,湖南长沙410013

出　　处：《临床肺科杂志》2021年第1期81-85,共5页Journal of Clinical Pulmonary Medicine

基　　金：湖南省卫生计生委科研计划课题项目(No.B2017147)。

摘　　要：目的探讨草分枝杆菌辅助治疗对耐多药肺结核患者临床疗效、免疫功能的影响。方法回顾性分析在我院接受治疗的耐多药肺结核患者86例。对照组42例,行常规治疗;观察组44例常规治疗加草分枝杆菌辅助治疗。对比两组疗效、免疫功能及不良反应,并分析耐多药肺结核治疗转归影响因素。结果治疗后两组IgG、IgM及CD8^+水平均明显上升,CD4^+水平明显下降,但观察组升高、下降更明显(P<0.05)。观察组不良反应发生率为36.36%,与对照组的42.86%无显著差异(P>0.05)。观察组治疗成功率为70.45%,高于对照组的42.86%,多因素分析结果显示,使用草分枝杆菌辅助治疗、治疗中影像学好转及治疗3个月痰菌转阴者治疗成功率更高,复发、不良反应所致永久性更改方案者,治疗成功率较低(P<0.05)。结论草分枝杆菌辅助治疗可显著提高耐多药肺结核患者治疗成功率,改善患者免疫功能且不增加不良反应发生率,耐多药肺结核患者治疗成功率与治疗中影像学好转、治疗3个月痰菌转阴、永久性更改方案有关。Objective To explore the effect of adjuvant treatment with Mycobacterium phlei on the clinical efficacy and immune function of patients with multi-drug resistant tuberculosis.Methods A retrospective analysis of 86 patients with MDR-TB received treatment in our hospital was conducted.42 cases in the control group were given routine treatment,and 44 cases in the observation group were given conventional treatment plus adjuvant treatment with Mycobacterium phlei.Their efficacy,immune function and adverse reactions were compared between the two groups,and the factors affecting the outcome of multi-drug resistant tuberculosis treatment were analyzed.Results After treatment,the levels of IgG,IgM and CD8^+in the two groups increased significantly,and the level of CD4^+decreased significantly,but the increase and decrease in the observation group were more pronounced than in the control group(P<0.05).The incidence of adverse reactions in the observation group was 36.36%,which was not significantly different from 42.86%in the control group(P>0.05).The treatment success rate of the observation group was 70.45%,which was higher than 42.86%of the control group.The results of multivariate analysis showed that the adjuvant treatment with Mycobacterium phlei,the imaging improvement during treatment and the treatment of sputum bacteria turned negative for 3 months had a higher treatment success rate.The rate of treatment success was lower for those who permanently changed the regimen due to relapse or adverse reactions(P<0.05).Conclusion Mycobacterium phlei adjuvant treatment can significantly improve the treatment success rate of MDR-TB patients,improve the immune function of patients and do not increase the incidence of adverse reactions.The treatment success rate of MDR-TB patients is related to the learning transformation of the image in the treatment,the negative transformation of sputum bacteria in the treatment for three months,and the permanent change scheme.

关 键 词：草分枝杆菌 耐多药肺结核 临床疗效 免疫功能 多因素分析 

分 类 号：R521[医药卫生—内科学]