耐多药肺结核患者应用环丝氨酸治疗的效果探析  

ffiAnalysis of the therapeutic efficacy of cycloserine treatment in patients with multidrug-resistant tuberculosis

作　　者：岳阳 李佳丽 李婷 王昕 YUE Yang;LI Jiali;LI Ting;WANG Xin(Department of Tuberculosis Internal Medicine,Heilongjiang Provincial Infectious Disease Control Hospital,Harbin 150500,China)

机构地区：[1]黑龙江省传染病防治院结核内科,哈尔滨150500

出　　处：《长春中医药大学学报》2025年第3期309-312,共4页Journal of Changchun University of Chinese Medicine

基　　金：黑龙江省卫生健康委科研课题(20230303110207)。

摘　　要：目的 基于免疫功能、痰菌阴转率及结核分枝杆菌/利福平耐药实时荧光定量核酸扩增检测技术(X-pert Mtb/RIF)分析环丝氨酸联合抗结核药物治疗耐多药肺结核(MDR-TB)的效果。方法 将105例MDR-TB患者随机分为对照组(52例)和试验组(53例)。2组均行常规对症治疗,对照组在此基础上加用常规抗结核药物,试验组在对照组基础上口服环丝氨酸胶囊,疗程均为6个月。比较2组痰菌转阴、空洞闭合、病灶吸收情况、Xpert Mtb/RIF检测结果、呼吸功能、免疫功能及不良反应。结果 治疗后,试验组的痰菌转阴、空洞闭合及病灶吸收率较对照组更高,Xpert Mtb/RIF检出痰结核杆菌阳性率较对照组更低(P<0.05)。治疗后,2组的最大呼气流量(PEF)、每分钟最大通气量(MVV)、用力肺活量(FVC)、第一秒呼气容积占比(FEV_(1))、CD4^(+)、CD4^(+)/CD8^(+)、免疫球蛋白M(IgM)、IgA较治疗前升高,且试验组较对照组更高;CD8^(+)降低,且试验组较对照组更低(P<0.05)。结论 MDR-TB患者应用环丝氨酸联合抗结核药物治疗的疗效显著,且安全性良好。Objective To analyze the efficacy of cycloserine combined with antituberculosis drugs in the treatment of multidrugresistant tuberculosis(MDR-TB)based on immune function,rate of sputum bacterial negative conversin,and real-time fluorescent quantitative nucleic acid amplification detection technology for Mycobacterium tuberculosis/rifampicin resistance(X-pert MTB/RIF).Methods 105 patients with MDR-TB were randomly divided into the control group(52 cases)and the experiment group(53 cases).Both groups received routine symptomatic treatment,the control group received routine antituberculosis drugs on this basis,while the experiment group received orally cycloserine capsules on the basis of the treatment of the control group.And the treatment course was 6 months for both groups.The sputum bacterial negative conversin,cavity closure,lesion absorption,Xpert Mtb/RIF tese results,respiratory function,immune function and adverse reactions of two groups were compared.Results After treatment,the rate of sputum bacterial negative conversin,cavity closure,and lesion absorption rate of the experiment group were higher than those of the control group.The positive rate of sputum bacterial negative conversin detected by Xpert Mtb/RIF was lower than that of the control group(P<0.05).After treatment,the maximum peak expiratory flow(PEF),maximum ventilation volume per minute(MVV),forced vital capacity(FVC),proportion of first second expiratory volume(FEV_(1)),CD4^(+),CD4^(+)/CD8^(+),immunoglobulin M(IgM),and IgA in both groups increased compared with before treatment,and the experiment group was higher than the control group;CD8^(+)decreased,and the experiment group was lower than the control group(P<0.05).Conclusion The use of cycloserine combined with antituberculosis drugs in the treatment of MDR-TB has significant efficacy and good safety.

关 键 词：耐多药肺结核 环丝氨酸 抗结核药物 免疫功能 痰菌阴转率 

分 类 号：R521[医药卫生—内科学]