贝达喹啉辅以环丝氨酸对耐多药肺结核老年患者的疗效  

Efficacy of Bedaquiline Supplemented with Cycloserine in Elderly Patients with Multidrug-resistant Pulmonary Tuberculosis

作　　者：凌婵 裴异 蒋之 Ling Chan;Pei Yi;Jiang Zhi(Department of lungⅡ,Changsha Central Hospital Affiliated to University of South China,Changsha 410004;Department of lungⅥ,Changsha Central Hospital Affiliated to University of South China,Changsha 410004)

机构地区：[1]南华大学附属长沙中心医院肺二科,长沙410004 [2]南华大学附属长沙中心医院肺六科,长沙410004

出　　处：《国际老年医学杂志》2023年第6期682-686,共5页International Journal of Geriatrics

基　　金：湖南省卫生健康委科研计划项目(20201439)。

摘　　要：目的探究贝达喹啉辅以环丝氨酸对耐多药肺结核老年患者的临床疗效。方法选取2019年4月~2021年4月在南华大学附属长沙中心医院收治的耐多药肺结核老年患者232例,按照分层抽样法分为对照组和联合组各116例,对照组采用环丝氨酸治疗,联合组采用贝达喹啉联合环丝氨酸治疗,采用酶联免疫法检测可溶性髓系细胞触发受体-1(sTREM-1)、对氧磷酶1(PON1)、C反应蛋白(CRP)、白细胞介素6(IL-6)、白细胞介素2(IL-2)、碱性磷酸酶(ALP)、丙氨酸转氨酶(ALT)、天门冬氨酸转氨酶(AST)、总蛋白(TP),采用肺功能仪检测第1秒用力呼气容积(FEV1)、FEV1/用力肺活量(FVC)、每分钟最大通气量(MVV)水平,观察两组治疗总有效率及不良反应发生率。结果治疗后,联合组肺功能水平高于对照组,差异有统计学意义(P<0.05);联合组CRP、IL-6、IL-2水平低于对照组,差异有统计学意义(P<0.05);联合组ALT、ALP、AST水平高于对照组,TP水平低于对照组,差异均有统计学意义(P<0.05);联合组sTREM-1、PON1表达量低于对照组,差异有统计学意义(P<0.05);联合组治疗总有效率高于对照组,差异有统计学意义(P<0.05);联合组总不良反应略高于对照组,但两组比较差异无统计学意义(P>0.05)。结论贝达喹啉、环丝氨酸联合应用可减轻耐多药肺结核老年患者肝累及损伤,抑制炎症反应,降低sTREM-1、PON1表达,修复结核感染损伤,效果显著。贝达喹啉、环丝氨酸联合应用总不良反应略高于对照组。Objective To investigate the clinical efficacy of bedaquiline combined with cycloserine in elderly patients with multidrug-resistant pulmonary tuberculosis.Methods A total of 232 elderly patients with multidrug-resistant pulmonary tuberculosis admitted to Changsha Central Hospital affiliated to University of South China from April 2019 to April 2021 were selected and divided into the control group and the combination group with 116 cases in each group according to the stratified sampling method.The control group was treated with cycloserine,and the combination group was treated with cycloserine.Bedaquiline combined with cycloserine treatment,the levels of soluble myeloid cell trigger receptor-1(sTREM-1),paraoxonase 1(PON1),C-reactive protein(CRP),interleukin-6(IL-6),and interleukin-2(IL-2)were detected by enzyme-linked immunosorbent assay.alkaline phosphatase(ALP),alanine aminotransferase(ALT),aspartate aminotransferase(AST),total protein(TP),forced expiratory volume in 1s(FEV1),FEV1/forced vital capacity(FVC)and maximum voluntary ventilcotion(MVV)levels,the total effective rate and the incidence of adverse reactions in the two groups were observed.Results After treatment,the level of pulmonary function in the combination group was higher than that in the control group,and the difference was statistically significant(P0.05);the levels of ALT,ALP,and AST in the combination group were higher than those in the control group,and the level of TP was lower than that in the control group,and the difference was statistically significant(P0.05).The total effective rate of the combined group was higher than that of the control group,and the difference was statistically significant(P0.05);the total adverse reactions in the combined group were slightly higher than those in the control group,but there was no significant difference between the two groups(P0.05).Conclusion The combined application of bedaquiline and cycloserine can reduce the liver involvement injury,inhibit the inflammatory reaction,reduce the expression of sT

关 键 词：贝达喹啉 环丝氨酸 耐多药肺结核 可溶性髓系细胞触发受体-1 对氧磷酶1 

分 类 号：R521[医药卫生—内科学]