纤维支气管镜治疗对气管支气管结核患者免疫及腺苷脱氨酶水平的影响  

The influence of fiberoptic bronchoscopy on immunity and ADA level of patients with tracheobronchial tuberculosis

作　　者：秦科宇 徐桂兴[1] 张志新[1] 徐蕾 QIN Ke-yu;XU Gui-xing;ZHANG Zhi-xin(Pulmonary Department,Changzhou Third People's Hospital,Changzhou 213001,China;不详)

机构地区：[1]常州市第三人民医院肺科,江苏常州213001 [2]常州市儿童福利院医务科,江苏常州213004

出　　处：《中国医学装备》2021年第10期106-109,共4页China Medical Equipment

摘　　要：目的:研究纤维支气管镜治疗方法对气管支气管结核患者免疫及腺苷脱氨酶(ADA)水平的影响。方法:选取在医院就诊的80例气管支气管结核患者,采用随机数表法将其分为观察组和对照组,每组40例。对照组采用常规治疗方法(四联抗结核全身化疗治疗),观察组在常规治疗的基础上采用纤维支气管镜治疗。比较两组患者痰菌转阴率、免疫功能T淋巴细胞亚群[CD4^(+)、CD8^(+)和T细胞比值(CD4^(+)/CD8^(+))]、腺苷脱氨酶(ADA)、γ干扰素(IFN-γ)和白细胞介素-4(IL-4)指标的差异。结果:观察组治疗后痰菌转阴率明显高于对照组,差异有统计学意义(x^(2)=5.000,P<0.05)。两组治疗后CD4^(+)、CD4^(+)/CD8^(+)较治疗前显著增高,差异有统计学意义(t_(观察组)=2.268,t=5.996;t_(对照组)=3.366,t=3.288;P<0.05),CD8^(+)较治疗前显著降低,差异有统计学意义(t_(观察组)=4.304,t_(对照组)=5.147;P<0.05)。治疗后,观察组CD4^(+)、CD4^(+)/CD8^(+)高于对照组,两组比较差异有统计学意义(t=2.229,t=4.685;P<0.05)。治疗后两组ADA指标与治疗前比较显著降低,IFN-γ和IL-4指标显著提高,差异有统计学意义(t_(观察组)=15.599,t=26.138,t=6.578;t_(对照组)=35.860,t=8.997,t=1.376;P<0.05);治疗后观察组ADA指标低于对照组,IFN-γ和IL-4指标高于对照组,两组比较差异有统计学意义(t=6.431,t=12.380,t=5.065;P<0.05)。结论:纤维支气管镜应用在气管支气管结核患者治疗中可改善痰菌转阴率,提高免疫功能,降低炎症水平,具有临床应用价值。Objective:To study the influence of fiberoptic bronchoscopy therapy on the immunity and adenosine deaminase(ADA)levels of patients with tracheobronchial tuberculosis.Methods:Eighty patients with tracheobronchial tuberculosis in hospital were enrolled in the study.They were randomly divided into observation group(n=40)and control group(n=40)according to random number table.The control group adopted conventionally therapeutic methods(tetralogy anti-tuberculosis systemic chemotherapy),and the observation group adopted fiberoptic bronchoscopy on the basis of conventional treatment.The differences of the negative conversion ratio of sputum bacterium,T lymphocyte subpopulation of immunologic function[CD4^(+),CD8^(+)and the ratio of T cell(CD4^(+)/CD8^(+))],ADA,IFN-γand interleukin-4(IL-4)between two groups were compared.Results:After treatment,the negative conversion rate of sputum bacterium of observation group was significantly higher than that of control group(x^(2)=5.000,P<0.05).The CD4^(+)and CD4^(+)/CD8^(+)levels in the two groups after treatment were significantly higher than those before treatment(tobservation group=2.268,t=5.996,t_(control)=3.366,t=3.288,P<0.05),respectively.The CD8^(+)levels in the two groups after treatment were significantly lower than those before treatment(tobservation group=4.304,t_(control group)=5.147,P<0.05),respectively.At the same time,the CD4^(+)and CD4^(+)/CD8^(+)levels of observation group were significantly higher than those of control group after treatment(t=2.229,t=4.685,P<0.05),respectively.The ADA indexes of the two groups after treatment were significantly lower than those before treatment,and the IFN-γand IL-4 indexes of two groups were significantly increased after treatment,the differences of them between before and after treatment was statistically significant(tobservation group=15.599,t=26.138,t=6.578,t_(control group)=35.860,t=8.997,t=1.376,P<0.05).In addition,the ADA index of observation group was significantly lower than that of control group after treatment,and t

关 键 词：纤维支气管镜 气管支气管结核 腺苷脱氨酶(ADA) 四联抗结核全身化疗治疗 

分 类 号：R523[医药卫生—内科学]