母牛分支杆菌菌苗免疫治疗肺结核临床观察——2年随访结果  

Immunotherapy with Mycobacterium vaccae vaccine in treating pulmonary tuberculosis -- results after 2 years' follow-up

作　　者：卢水华 刘志成 陈绪汉 吴同柱 王汉香 汪自然 顾晓洪 王彦君 徐烨 朱庭菊 谭刚华 徐学文 王国治[2] 庄玉辉[3] 

机构地区：[1]武汉铁路结核病防治院,武汉430083 [2]中国药品生物制品检定所,北京100050 [3]解放军309医院结核病研究室,北京100091

出　　处：《中国防痨杂志》2002年第6期324-326,共3页Chinese Journal of Antituberculosis

摘　　要：目的　评价母牛分支杆菌 (M .vaccae)菌苗免疫治疗缩短初治菌阳肺结核化疗疗程及对耐多药肺结核的疗效。方法　 14 2例初治菌阳肺结核和 4 6例耐多药肺结核 ,配对随机分为M .vaccae菌苗免疫治疗组和单纯化疗对照组。初治治疗组 (A组 )采用M .vaccae菌苗深部肌肉注射 6次及 4个月化疗 ,初治对照组 (B组 )采用 6个月化疗而不行免疫治疗 ;耐多药肺结核 (C组、D组 )均给予 18个月化疗 ,但治疗组 (C组 )给予M .vaccae菌苗免疫治疗 6次 ,对照组 (D组 )单用化疗。M .vaccae菌苗免疫治疗结束 ,A组痰菌阴转率为 95 .8% (6 8 71) ,B组为 97.2 % (6 9 71) ,P >0 .0 5 ;C组和D组痰菌阴转率分别为 34.8% (8 2 3)和 4 .7% (1 2 3) ,P <0 .0 5。本文对疗程结束痰菌阴转且未失访的14 1例病人进行了 2年随访。结果　A组 2年复发率为 6 .3% (4 6 4) ,B组为 4 .5 % (3 6 6 )P >0 .0 5 ,C组、D组 2年复发率分别为 11.1% (1 9)和 5 0 .0 % (1 2 ) ,P >0 .0 5。结论　M .vaccae菌苗免疫治疗可将初治菌阳肺结核的化疗疗程缩短为 4个月 ,痰菌阴转率、2年复发率与对照组无差异 ,耐多药肺结核痰菌阴转率明显提高 ,复发率与对照组无差异。因此 ,M .vaccae菌苗免疫治疗可缩短初治菌阳肺结核的疗程 ,提高耐多药肺结核的疗效 。Objective To further shorten the therapeutic period of short course chemotherapy (SCC) of initially treated pulmonary tuberculosis (PTB) and to improve the results of chemotherapy of MDR pulmonary tuberculosis by immunotherapy with Mycobacterium vaccae vaccine.Methods 142 patients of newly diagnosed pulmonary tuberculosis with bacteriological positive and 46 patients of MDR pulmonary tuberculosis were divided into immunotherapy groups (group A?C) control groups (group B?D) at randomized pair,group A (71 cases) of newly diagnosed PTB was received once monthly of injection of Mycobacterium vaccae vaccine as immunotherapy for 6 times and a 4 months chemotherapeutic regime,group B (71 cases) of newly diagnosed PTB was received a 6 months chemotherapentic regime,groups C?D of MDR pulmonary tuberculosis were received 18 months chemotherapeutic regime and group C (23 cases) was given six times injection once monthly of M.vaccae vaccine as immunotherapy.Results After 6 months,the sputum negative conversion rate of group A was 95.8%(68/71),group B was 97.2%(69/71), P >0.05;group C was 34.8%(8/23),group D was 4.7%(1/23), P <0.05,at the end of treatment of MDR pulmonary tuberculosis,group C was 39.1%(9/23),group D was 8.6%(2/23),at the final follow up after 2 years,the bacteriological relapse rate of group A was 6.3%(4/64),group B was 4.5%(3/66), P >0.05;and group C was 11.1%(1/9),group D was 50.0%(1/2), P >0.05.Conclusion As an adjunct to chemotherapy,M.vaccae vaccine was helpful for patients with pulmonary tuberculosis.

关 键 词：母牛分支杆菌 菌苗免疫 治疗 肺结核 免疫疗法 

分 类 号：R521[医药卫生—内科学]