母牛分枝杆菌预防结核分枝杆菌潜伏感染人群发生肺结核疾病的效果评价  

Evaluation on prevention effectiveness of pulmonary tuberculosis in individuals with latent infection of Mycobacterium tuberculosis by injection of Mycobacterium bovis

作　　者：刘敏[1] 边焕庆 郑珊红[3] 刘庆福 LIU Min;BIAN Huan-qing;ZHENG Shan-Hong;LIU Qing-fu(Respiratory DepartmintⅡ,Tai'an Tumor Prevention and Treatment Hospital,Tai'an,Shandong 271000,China;Taian City Center for Disease Control and Prevention;Tai'an Tumor Prevention and Treatment Hospital;Shandong Anti-Tuberculosis Association)

机构地区：[1]泰安市肿瘤防治院呼吸二科,山东271000 [2]泰安市疾病预防控制中心 [3]泰安市肿瘤防治院 [4]山东省防痨协会

出　　处：《预防医学论坛》2023年第6期465-469,共5页Preventive Medicine Tribune

摘　　要：目的 探讨注射用母牛分枝杆菌对预防结核分枝杆菌潜伏感染人群发生肺结核疾病的效果,并探讨机制。方法 选择2018年1月-2020年1月泰安市肿瘤防治院体检筛查确定为结核分枝杆菌潜伏感染的患者240例作为研究对象,随机数字抽取表法分为3组,每组各80例。将未采取治疗者作为对照组,采取常规抗结核化学药物治疗者作为药物预防组,采取注射用母牛分枝杆菌治疗者作为免疫预防组。测定治疗前、治疗1个月及治疗6个月三组外周血淋巴细胞亚群、细胞内细胞因子变化,统计三组不良反应发生率,随访3年观察三组肺结核发病率。结果 治疗3个月时,免疫预防组CD3^(+)、CD4^(+)高于药物预防组(t值分别为7.115、7.777,P<0.05)及对照组(t值分别为7.115、7.777、13.393、12.745,P<0.05),药物预防组高于对照组(t值分别为6.276、5.696,P<0.05),且免疫预防组与药物预防组CD8^(+)、NK、NKT、γδT高于对照组(t值分别为22.795、3.708、13.782、32.323、22.164、3.177、16.590、31.903,P<0.05);治疗6个月时,免疫预防组CD3^(+)、CD4^(+)、CD8^(+)高于药物预防组(t值分别为5.698、6.975、6.435,P<0.05)及对照组(t值分别为14.175、16.690、37.895,P<0.05),药物预防组高于对照组(t值分别为8.111、7.240、23.454,P<0.05),且免疫预防组NK、NKT、γδT低于药物预防组(t值分别为8.172、6.384、31.053,P<0.05)。治疗3个月时,免疫预防组IL-4、IFN-γ低于药物预防组(t值分别为5.926、16.153,P<0.05)与对照组(t值分别为16.839、13.413,P<0.05),药物预防组IL-4低于对照组(t=7.920,P<0.05),IFN-γ高于对照组(t=4.743,P<0.05)。治疗6个月时,免疫预防组IL-4低于药物预防组(t=6.382,P<0.05)与对照组(t=40.554,P<0.05),IFN-γ高于药物预防组(t=8.888,P<0.05),低于对照组(t=2.876,P<0.05),药物预防组IL-4、IFN-γ低于对照组(t值分别为24.851、13.070,P<0.05)。对照组、药物预防组、免疫预防组不良反应发生率分别为0.00%(0/80)�Objective To explore the effectiveness of Mycobacterium tuberculosis injection in preventing pulmonary tuberculosis in individuals with latent infection of Mycobacterium tuberculosis,and to explore its mechanism.Methods A total of 240 patients with latent infection of Mycobacterium tuberculosis confirmed by hospital physical examination screening from January 2018 to January 2020 were selected as the research subjects.They were randomly divided into 3 groups using a random number extraction table,with 80 cases in each group.Those who did not take treatment were taken as the control group,those who took conventional antituberculosis chemical drug treatment were taken as the drug prevention group,and those who took mycobacterium vaccae injection treatment were taken as the immune prevention group.The changes of peripheral blood lymphocyte subsets and intracellular cytokines in 3 groups were measured before treatment,l month after treatment and 6 months after treatment.The incidence of adverse reactions in the 3 groups was counted.The incidence of pulmonary tuberculosis in the 3 groups was observed after3years of follow-up.Results At the end of 3 months of treatment,the levels of CD3^(+)and CD4^(+)in the immunoprophylactic group were higher than those in the drug prophylactic group(t=7.115,7.777,P<0.05)and the control group(t=7.115,7.777,t=13.393,12.745,P<0.05),and they were higher in drug prophylactic group than in the control group(t=6.276,5.696,P<0.05),meanwhile the levels of CD8+,NK,NKT and 8 T in the immunoprophylactic group and drug prophylactic group were higher than those in the control group(t=6.276,5.696,P<0.05)was higher than the control group(t=22.795,3.708,13.782,32.323,t=22.164,3.177,16.590,31.903,P<0.05);At 6 months of treatment,the levels of CD3^(+),CD4^(+),and CD8^(+)in the immunoprophylactic group were higher than those in the drug prophylactic group(t=5.698,6.975,6.435,P<0.05)and the control group(t=14.175,16.690,37.895,P<0.05),and they were higher in drug prophylactic group than in control group(

关 键 词：结核分枝杆菌 潜伏感染 母牛分枝杆菌 肺结核 细胞免疫 

分 类 号：R378.91[医药卫生—病原生物学]