地塞米松胸腔内注射辅助2HRZE/4HR方案治疗老年渗出性结核性胸膜炎的效果  

Effect of Dexamethasone Intrapleural Injection Assisted with 2HRZE/4HR Regimen in the Treatment of Elderly Exudative Tuberculous Pleurisy

作　　者：郝冠磊 尚双霞 赵庆伟 HAO Guanlei;SHANG Shuangxia;ZHAO Qingwei(Department of Pharmaceutical Dispensing,General Hospital of Pingmei Shenma Group,Pingdingshan 467000,Henan,China)

机构地区：[1]平煤神马医疗集团总医院药品调剂科,河南平顶山467000

出　　处：《中国药物滥用防治杂志》2024年第2期292-295,299,共5页Chinese Journal of Drug Abuse Prevention and Treatment

摘　　要：目的:探讨地塞米松胸腔内注射联合2HRZE/4HR方案治疗老年渗出性结核性胸膜炎的治疗效果。方法:纳入2020年6月—2022年6月本院140例老年渗出性结核性胸膜炎患者为研究对象,采用随机数字表法分为观察组和对照组,每组70例。两组均给予常规治疗,对照组应用2HRZE/4HR方案治疗,观察组应用地塞米松胸腔内注射联合2HRZE/4HR方案治疗,均持续治疗6个月。比较两组炎症因子水平[肿瘤坏死因子-α(TNF-α)、干扰素-γ(IFN-γ)、白细胞介素-10(IL-10)]、Th1、Th2细胞比例和Th1/Th2以及肺功能指标[第一秒用力呼气容积占预计值百分比(FEV1%pred)、呼气流量峰值(PEF)、一秒率(FEV1/FVC)]。另记录患者临床症状改善情况(完全退热时间、胸腔积液吸收时间、胸膜厚度减少量)。结果:观察组血清TNF-α、IFN-γ水平低于对照组,血清IL-10水平高于对照组,差异有统计学意义(P<0.05);观察组Th1细胞比例、Th1/Th2低于对照组,差异有统计学意义(P<0.05);观察组胸腔积液吸收时间短于对照组,胸膜厚度减少量高于对照组(P<0.05),而两组完全退热时间比较,差异无统计学意义(P>0.05);观察组FEV1%pred、PEF、FEV1/FVC水平均高于对照组,差异有统计学意义(P<0.05)。结论:地塞米松胸腔内注射联合2HRZE/4HR方案可有效减轻老年渗出性结核性胸膜炎炎症反应,纠正Th1/Th2细胞比例失衡,改善患者临床症状及其肺功能。Objective:To explore the therapeutic effect of dexamethasone intrapleural injection combined with 2HRZE/4HR regimen in the treatment of elderly exudative tuberculous pleurisy.Methods:A total of 140 elderly patients with exudative tuberculous pleurisy in our hospital from June 2020 to June 2022 were included as the study subjects.They were randomly divided into an observation group and a control group using a random number table method,with 70 patients in each group.Both groups were given routine treatment,the control group was treated with the 2HRZE/4HR regimen,and the observation group was treated with dexamethasone intrapleural injection combined with the 2HRZE/4HR regimen,both of which continued for 6 months.The levels of inflammatory factors[tumor necrosis factor-α(TNF-α),interferon-γ(IFN-γ),interleukin-10(IL-10)],Th1 and Th2 cell ratios,Th1/Th2,and lung function indicators[percentage of first second forced expiratory volume to predicted value(FEV1%pred),peak expiratory flow(PEF),and one second rate(FEV1/FVC)]were compared between two groups.Additionally,the improvement of the patient's clinical symptoms were recorded(complete fever relief time,pleural effusion absorption time,and decrease in pleusral thickness).Results:The serum levels of TNF-αand IFN-γin the observation group were lower than those in the control group,and the serum level of IL-10 was higher than that in the control group,the differences were statistically significant(P<0.05).The proportion of Th1 cells and Th1/Th2 in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The absorption time of pleural effusion in the observation group was shorter than that in the control group,and the reduction of pleural thickness was higher than that in the control group(P<0.05),but there was no significant difference in the complete antipyretic time between the two groups(P>0.05).The levels of FEV1%pred,PEF and FEV1/FVC in the observation group were higher than those in the contro

关 键 词：老年人 结核性胸膜炎 胸腔积液 地塞米松 炎症因子 

分 类 号：R521.7[医药卫生—内科学]