胸腺五肽联合左氧氟沙星在复治菌阳肺结核治疗中的应用效果  

Effect of thymopentin combined with levofloxacin for retreatment smear positive pulmonary tuberculosis

作　　者：戴春燕 刘一典[2] 缪璟榕 田甜 丛惠敏 诸国兵 DAI Chunyan;LIU Yidian;MIAO Jingrong;TIAN Tian;CONG Huimin;ZHU Guobing(Department of Infection,Rudong County People's Hospital,Nantong,Jiangsu 226400,China;Department of Tuberculosis,Shanghai Pulmonary Hospital,Shanghai 200433,China;Department of Pharmacy,Nantong First People's Hospital,Nantong,Jiangsu 226006,China)

机构地区：[1]如东县人民医院感染科,江苏南通226400 [2]上海市肺科医院结核科,上海200433 [3]南通市第一人民医院药剂科,江苏南通226006

出　　处：《中国热带医学》2023年第7期742-747,共6页China Tropical Medicine

摘　　要：目的 分析胸腺五肽辅助左氧氟沙星在复治菌阳肺结核治疗中的应用效果及其对呼吸功能、免疫功能、炎性因子的影响。方法 将2017-2021年江苏省南通市如东县人民医院收治的100例复治菌阳肺结核患者采用随机数字表法分组对照组(50例)与观察组(50例)。两组均接受常规治疗(3个月异烟肼、利福平、乙胺丁醇、吡嗪酰胺/6个月异烟肼、利福平、乙胺丁醇),对照组在常规治疗基础上联合左氧氟沙星,观察组在对照组基础上前3个月联合应用胸腺五肽,对比两组治疗效果。结果 观察组治疗3个月、治疗5个月痰菌转阴率高于对照组,差异有统计学意义(χ^(2)=7.142,P<0.05;χ^(2)=6.250,P<0.05);观察组空洞吸收时间及病灶吸收时间低于对照组,差异有统计学意义(t=4.006,P<0.05;t=5.165,P<0.05);观察组细菌学培养转阴时间低于对照组,差异有统计学意义(t=4.220,P<0.05);治疗后3个月观察组CD4+、CD3+百分比、CD4+/CD8+值高于对照组,差异有统计学意义(t=8.885,P<0.05;t=6.274,P<0.05;t=4.357,P<0.05);治疗后3个月研究组γ干扰素(interferon-γ, IFN-γ)高于对照组(t=8.892,P<0.05),白细胞介素10(interleukin-10,IL-10)低于对照组(t=5.986,P<0.05),差异有统计学意义;治疗后3个月观察组用力肺活量(forced vital capacity, FVC)、第1秒用力呼气量(forced expiratory volume in one second, FEV1)和第1秒用力呼气量占用力呼气量百分比(forced expiratory volume in one second/forced vital capacity, FEV1/FVC)高于对照组,差异有统计学意义(t=11.223,P<0.05;t=10.128,P<0.05;t=4.464,P<0.05);不良反应发生率观察组与对照组相比,差异无统计学意义(χ^(2)=0.378,P>0.05)。结论 胸腺五肽联合左氧氟沙星在复治菌阳肺结核治疗中应用效果显著,对于患者炎性反应、呼吸功能及免疫功能的改善有利,同时可提高痰转阴率,加快患者康复速度,能够使患者整体疗效提高,具备较高的临床应用价值。Objective To analyze the effect of adjuvant to levofloxacin in the treatment of retreatment smear positive pulmonary tuberculosis,as well as its effect on respiratory function,immune function and inflammatory factors.Methods One hundred cases of retreatment smear positive pulmonary tuberculosis patients admitted to Rudong County People's Hospital in Nantong city in Jiangsu province from 2017 to 2021 were randomly divided into a control group(n=50)and an observation group(n=50)according to random number table method.Both groups received conventional treatment(3 months of isoniazid,rifampicin,ethambutol,pyrazinamide/6 months of isoniazid,rifampicin,ethambutol),with levofloxacin added to the control group,and thymopentin added to the observation group for the first three months in addition to routine treatment.The treatment effect of the two groups were compared.Results The sputum smear conversion rate of the observation group was significantly higher than that of the control group after 3 months and 5 months of treatment(χ^(2)=7.142,P<0.05;χ^(2)=6.250,P<0.05).The cavity absorption time and lesion absorption time in the observation group were significantly lower than those in the control group(t=4.006,P<0.05;t=5.165,P<0.05).The turning time of bacteriological culture in the observation group was significantly lower than that in the control group(t=4.220,P<0.05).After 3 months of treatment,CD4+,CD3+,CD4+/CD8+of the observation group were higher than those of the control group,the differences were statistically significant(t=8.885,P<0.05;t=6.274,P<0.05;t=4.357,P<0.05).After 3 months of treatment,the IFN-γ(interferon-γ)of the observation group was higher than that of the control group(t=8.892,P<0.05),whereas the,IL-10(interleukin-10)was significantly lower than that in the control group(t=5.986,P<0.05).After 3 months of treatment,forced vital capacity(FVC),forced expiratory volume in one second(forced expiratory volume in one second,FEV 1)and the one-second rate(forced expiratory volume in one second/forced vital c

关 键 词：复治菌阳肺结核 左氧氟沙星 胸腺五肽 呼吸功能、炎性因子 免疫功能 

分 类 号：R521[医药卫生—内科学]