糖皮质激素联合2HRZE/7HRE治疗结核性胸膜炎的效果及对患者免疫能力的影响  

Effect of glucocorticoids combined with 2HRZE/7HRE in the treatment of tuberculous pleurisy and its impact on the immune function of patients

作　　者：苗学红 郭雪敏 李静[1] Miao Xuehong;Guo Xuemin;Li Jing(不详;Department of Juvenile Tuberculosis,Zhengzhou Sixth People′s Hospital,Henan 450000,China)

机构地区：[1]郑州市第六人民医院青少年结核病科,450000 [2]郑州市第六人民医院中老年结核病科,450000

出　　处：《山西医药杂志》2024年第20期1533-1536,共4页Shanxi Medical Journal

摘　　要：目的探讨糖皮质激素联合2HRZE/7HRE治疗结核性胸膜炎的效果及对患者免疫能力的影响。方法70例结核性胸膜炎患者予以随机分组,对照组应用2HRZE/7HRE常规抗结核方案治疗,观察组另外加用糖皮质激素(醋酸泼尼松片)治疗。比较2组治疗效果,治疗前后免疫功能、血清炎性指标水平,不良反应发生率。结果观察组治疗有效率较对照组(94.3%和74.3%)明显更高(P<0.05)。治疗后,观察组CD3^(+)、CD4^(+)、CD8^(+)水平与CD4^(+)/CD8^(+)比值均明显改善,且相较对照组更具优势(P<0.05)。治疗后,观察组炎性指标水平改善情况优于对照组(P<0.05)。2组不良反应率(14.3%和11.4%)比较差异无统计学意义(P>0.05)。结论糖皮质激素联合2HRZE/7HRE治疗结核性胸膜炎的效果显著,可加速患者临床症状改善,还能提升患者机体免疫能力,缓解炎性反应,且联合用药安全性可靠,值得临床推广。Objective To explore the effect of glucocorticoids combined with 2HRZE/7HRE in the treatment of tuberculous pleurisy and its impact on the patient′s immune function.Methods A total of 70 patients with tuberculous pleurisy were randomly divided into two groups.The control group received routine treatment with the 2HRZE/7HRE anti-tuberculosis regimen,while the observation group received additional treatment with glucocorticoids(prednisone acetate tablets).Compare the therapeutic effects,immune function,serum inflammatory index levels,and incidence of adverse reactions between the two groups before and after treatment.Results The effective rate of treatment in the observation group was significantly higher than that in the control group(94.3%vs 74.3%)(P<0.05).After treatment,the levels of CD3^(+),CD4^(+),CD8^(+)and CD4^(+)/CD8^(+)ratio in the observation group were significantly improved,and they were more advantageous than the control group(P<0.05).After treatment,the improvement of inflammatory indicators in the observation group was better than that in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(14.3%vs 11.4%)(P>0.05).Conclusion The combination of glucocorticoids and 2HRZE/7HRE has a significant effect on the treatment of tuberculous pleurisy.It can accelerate the improvement of clinical symptoms in patients,enhance their immune function,alleviate inflammatory reactions,and the combination therapy is safe and reliable,which is worthy of clinical promotion.

关 键 词：糖皮质激素类 结核 胸膜炎 2HRZE/7HRE抗结核 免疫功能 炎性反应 

分 类 号：R521.7[医药卫生—内科学]