利福喷丁对菌阳肺结核患者血清IP-10、SOCSⅠ、AST、ALT水平的影响  

Effect of rifapentine on serum levels of IP-10,SOCSⅠ,AST,and ALT in patients with mycobacterium tuberculosis-positive pulmonary tuberculosis

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

机构地区：[1]黑龙江省传染病防治院综合内科,哈尔滨150500 [2]黑龙江省传染病防治院结核内科,哈尔滨150500

出　　处：《西北药学杂志》2025年第2期146-152,共7页Northwest Pharmaceutical Journal

基　　金：黑龙江省卫生健康委科研课题(编号:20230303110207)。

摘　　要：目的探讨利福喷丁对菌阳肺结核(pulmonary tuberculosis,PTB)患者血清γ干扰素诱导蛋白(recombinant interferon gamma induced protein 10 kDa,IP-10)、细胞因子信号转导抑制物Ⅰ(suppressor of cytokine signalingⅠ,SOCSⅠ)、天门冬氨酸氨基转移酶(aspartate aminotransferase,AST)、丙氨酸氨基转移酶(alanine aminotransferase,ALT)水平的影响。方法以2021年5月—2023年8月于黑龙江省传染病防治院接受治疗的菌阳PTB患者106例作为研究对象,用随机数字表法分为2HRZE/4HRE组和2HLZE/4HLE组,每组53例。2HRZE/4HRE组给予2HRZE/4HRE抗结核方案(利福平片+异烟肼片+盐酸乙胺丁醇片+吡嗪酰胺片),2HLZE/4HLE组给予2HLZE/4HLE抗结核方案(利福喷丁胶囊+异烟肼片+盐酸乙胺丁醇片+吡嗪酰胺片)。2组均治疗6个月。比较2组治疗6个月后的临床疗效,空洞闭合率,病灶吸收率,治疗前、治疗6个月后的免疫功能、炎症反应指标及血清IP-10、SOCSI、AST、ALT水平,治疗期间的安全性。结果治疗6个月后,2HLZE/4HLE组的总有效率高于2HRZE/4HRE组(79.25%vs.96.23%,P<0.05)。治疗6个月后,2组的全血免疫球蛋白A(immunoglobulin A,IgA)、免疫球蛋白G(immunoglobulin G,IgG)及血清SOCSⅠ水平均升高,且2HLZE/4HLE组更高(P<0.05);2组血清白细胞介素-1β(interleukin-1β,IL-1β)、γ-干扰素(interferon-γ,IFN-γ)及IP-10水平均降低,且2HLZE/4HLE组的上述指标更低;2组血清AST、ALT水平均升高,但2HLZE/4HLE组低于2HRZE/4HRE组(P<0.05)。2HLZE/4HLE组的不良反应发生率低于2HRZE/4HRE组(5.66%vs.22.64%,P<0.05);治疗6个月后,2HLZE/4HLE组的空洞闭合率、病灶吸收率分别为81.13%、92.45%,高于2HRZE/4HRE组的60.38%、73.58%,均P<0.05。结论利福喷丁治疗菌阳PTB的效果较好,可有效改善患者的免疫功能,调节血清IP-10、SOCSⅠ水平,减轻患者的炎症反应及肝功能损伤,且具有较高的安全性。Objective To investigate the effects of rifapentine on the level of serum recombinant interferon gamma induced protein 10 kDa(IP-10),suppressor of cytokine signalingⅠ(SOCSⅠ),aspartate aminotransferase(AST),and alanine aminotransferase(ALT)in patients with positive pulmonary tuberculosis(PTB).Methods A total of 106 patients with bacterial positive PTB who received treatment at the Infectious Disease Prevention and Control Hospital of Heilongjiang Province from May 2021 to August 2023 were selected as the study subjects.They were divided into the 2HRZE/4HRE group and the 2HLZE/4HLE group by random number table,with 53 patients in each group.The 2HRZE/4HRE group was given the 2HRZE/4HRE anti tuberculosis regimen(Rifampicin Tablets+Isoniazid Tablets+Ethambutol Hydrochloride Tablets+Pyrazinamide Tablets),while the 2HLZE/4HLE group was given the 2HLZE/4HLE anti tuberculosis regimen(Rifampicin Capsules+Isoniazid Tablets+Ethambutol Hydrochloride Tablets+Pyrazinamide Tablets).Both groups received treatment for 6 months.Clinical efficacy,rate of cavity closure,rate of focus absorption after 6 months of treatment,immune function,inflammatory response,and the levels of serum IP-10,SOCSⅠ,AST,and ALT before and after 6 months of treatment,and the safety during the treatment period were compared between the 2 groups.Results After 6 months of treatment,the total effective rate of the 2HLZE/4HLE group was higher than that of the 2HRZE/4HRE group(79.25%vs.96.23%,P<0.05).After 6 months of treatment,the levels of whole blood immunoglobulin A(IgA),immunoglobulin G(IgG),and serum SOCSⅠincreased in both groups,and the 2HLZE/4HLE group were higher(P<0.05);The levels of serum interleukin-1β(IL-1β),γ-interferon(IFN-γ),and IP-10 were all reduced in both groups,and the 2HLZE/4HLE group were lower;The levels of serum AST and ALT in both groups all increased;however,the 2HLZE/4HLE group were lower than the 2HRZE/4HRE group(P<0.05).The incidence of adverse reactions in the 2HLZE/4HLE group was lower than that in the 2HRZE/4HRE grou

关 键 词：肺结核 利福喷丁 γ-干扰素诱导蛋白 细胞因子信号转导抑制物Ⅰ 天门冬氨酸氨基转移酶 丙氨酸氨基转移酶 

分 类 号：R974[医药卫生—药品]