胸腺法新辅助2HREZ/4HR治疗重症肺结核的效果观察  

Observation on the Efficacy of Thymalfasin Assisting 2HREZ/4HR in the Treatment of Severe Pulmonary Tuberculosis

作　　者：黄雅萍 吴琪茵 郭毓娟 HUANG Yaping;WU Qiyin;GUO Yujuan(Zhangzhou Affiliated Hospital of Fujian Medical University,Zhangzhou 363000,China;不详)

机构地区：[1]福建医科大学附属漳州市医院,福建漳州363000

出　　处：《中国医学创新》2023年第30期36-40,共5页Medical Innovation of China

摘　　要：目的:探讨胸腺法新辅助标准化疗方案(2HREZ/4HR)治疗重症肺结核的效果。方法:选择2019年9月—2021年9月福建医科大学附属漳州市医院收治的重症肺结核患者90例作为研究对象,按照随机数字表法分为两组,各45例,对照组采取2HREZ/4HR治疗,观察组采取胸腺法新辅助2HREZ/4HR治疗,记录两组症状改善时间,观察治疗后患者的痰转阴率、病灶吸收率、空洞闭合率,测定治疗前、治疗后患者的T淋巴细胞亚群计数及细胞因子水平变化。结果:观察组高热、咳痰、盗汗、乏力等症状改善时间均短于对照组(P<0.05)。治疗3、6、12个月后,观察组痰转阴率为84.44%、93.33%、97.78%,均高于对照组的60.00%、77.78%、84.44%(P<0.05);观察组病灶吸收率为77.78%、88.89%、93.33%,均高于对照组的53.33%、71.11%、75.56%(P<0.05);观察组空洞闭合率为68.89%、75.56%、80.00%,均高于对照组的44.44%、55.56%、57.78%(P<0.05)。治疗后,观察组的CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)比对照组均更高,CD8^(+)更低(P<0.05)。治疗后,观察组的肿瘤坏死因子-α(TNF-α)、白细胞介素-4(IL-4)、干扰素-γ(IFN-γ)比对照组均更低(P<0.05)。结论:重症肺结核患者采取胸腺法新辅助2HREZ/4HR治疗可促进症状快速改善,促使病灶吸收、痰转阴及空洞闭合,而且具有良好的免疫调节作用,恢复机体细胞免疫功能平衡,治疗价值较高。Objective:To investigate the therapeutic effect of Thymalfasin assisting standard chemotherapy regimen(2HREZ/4HR)on severe pulmonary tuberculosis.Method:A total of 90 patients with severe pulmonary tuberculosis admitted to Zhangzhou Affiliated Hospital of Fujian Medical University from September 2019 to September 2021 were selected as the study objects,and they were divided into two groups with 45 cases in each group by random number table method.The control group received 2HREZ/4HR treatment,and the observation group received Thymalfasin assisting 2HREZ/4HR treatment.The symptom improvement time of the two groups was recorded.The sputum conversion rate,focus absorption rate and cavity closure rate of patients were observed after treatment.The T lymphocyte subsets count and cytokine levels were measured before and after treatment.Result:The improvement time of symptoms such as high fever,expectoration,night sweating and fatigue in observation group were shorter than those in control group(P<0.05).At 3,6 and 12 months after treatment,the sputum negative conversion rates in the observation group were 84.44%,93.33%and 97.78%,which were higher than the 60.00%,77.78%and 84.44%in the control group(P<0.05);the absorption rates of lesions in the observation group were 77.78%,88.89%and 93.33%,which were higher than 53.33%,71.11%and 75.56%in the control group(P<0.05);the closure rates of cavities in the observation group were 68.89%,75.56%and 80.00%,which were higher than 44.44%,55.56%and 57.78%in the control group(P<0.05).After treatment,CD3^(+),CD4^(+),CD4^(+)/CD8^(+)were higher and CD8^(+)were lower in observation group than those in control group(P<0.05).After treatment,the levels of TNF-α,IL-4 and IFN-γin the observation group were lower than those in the control group(P<0.05).Conclusion:Thymalfasin assisting 2HREZ/4HR treatment for severe pulmonary tuberculosis patients can promote rapid improvement of symptoms,promote lesion absorption,sputum conversion to negative,and cavity closure.It also has a good immune regu

关 键 词：重症肺结核 胸腺法新 标准化疗方案 痰转阴 T 淋巴细胞亚群 

分 类 号：R521[医药卫生—内科学]