摘要
目的探讨雾化吸入重组人干扰素-γ（rhlFN-γ）对复治耐多药肺结核患者免疫功能的变化。方法选择复治耐多药肺结核患者76例，随机分为两组：治疗组38例，给予雾化吸入rhlFN-γ 100万U，隔日1次，疗程为8周；对照组38例，雾化吸入异烟肼0．1 g＋阿米卡星0．2g，每日1次，疗程为8周。两组患者给予的抗结核治疗方案均为3HREZ（S）／6HRE，或根据药物敏感试验结果调整用药。治疗前、4周末、8周末分别采用流式细胞仪检测外周血中T淋巴细胞亚群：CD，、CD。、CD。；应用酶联免疫吸附法检测外周血中细胞因子：可溶性白细胞介素-2受体（sIL-2R）、IL-4、TNF—α。另选38例健康者作为正常组。结果治疗前治疗组和对照组患者外周血中T淋巴细胞亚群（CD3：0．45±0．02和0．43±0．08，CD4：0．34±0．04和0．35±0．06，CD8：0．29±0．08和0．28±0.03）与正常组（CD3：0．75±0．03，CD4：0．55±0．05，CD8：0．24±0．03）比较，差异均有统计学意义。治疗前治疗组和对照组患者外周血中细胞因子[sIL-2R：（12．05±2．18）pmol／L和（11．45±2．28）pmol／L，IL-4：（12．45±2．25）pg／L和（11．85±2．28）pg／L，TNF—α：（10．45±3．08）pg／L和（11．85±2．93）pg／L]与正常组[sIL-2R：（6．45±2．45）pmol／L，IL-4：（6．35±2．88）pg／L，TNF—α：（18．55±2．58）pg／L]比较，差异均有统计学意义。治疗组4周末和8周末，外周血中T淋巴细胞亚群和细胞因子与治疗前比较，差异均有统计学意义；对照组在8周末与治疗前比较，差异均有统计学意义。结论rhlFN-γ作为一种免疫调节剂，雾化吸人治疗复治耐多药肺结核能明显调节患者机体的免疫功能。
Objective To explore the changes of immunological function in the retreatment mul- ti-drug resistance pulmonary tuberculosis （MDR-PT） cases with aerosolizing inhalation of recombined human interferon-gamma （rhIFN- γ ）. Methods Seventy-six retreatment MDR-RT cases were divided into two groups randomly：treatment group （38 cases） and control group （38 cases）. The patients in treatment group were given aerosolized inhalation of rhIFN- γ one million U, one time in two days （eight weeks）. The patients in control group were given aerosolized inhalation of isoniazid 0.1 g and amikacin 0.2 g, one time in a day （eight weeks ）. All cases in two groups were given anti-tuberculosis therapy. The regimes was 3HREZ （S） /6HRE, or adjusted medicines according to the results of drug sensitivity test. T lymphocytes subsets （CD3, CD4 and CDs） were assayed by flow cytometry. Cytokines [ soluble intedeukin-2 receptor （sIL-2R）, inter- leukin-4（IL-4） and tumor necrosis factor- alpha （TNF- α） ] were detected by enzyme-hnked immunosorbent assay （ELISA）. Thirty-eight health people were admitted into health group. Results There was sig- nificant difference of CD3 （0.45 ± 0.02 and 0.43 ± 0.08 ）, CD4 （0.34 ± 0.04 and 0.35 ± 0.06）, CDa （0.29 ± 0.08 and 0.28 ± 0.03）, sIL-2R [ （ 12.05 ± 2.18 ）pmol/L and （ 11.45 ± 2.28 ）pmol/L], IL-4 [ （ 12.45 ± 2.25 ） pg/L and （ 11.85 ± 2.28 ）pg/L], and TNF- α [ （ 10.45 ± 3.08）pg/L and （ 11.85 ± 2.93）pg/L] in treatment group and control group compared with those in health group [ 0.75 ± 0.03,0.55 ± 0.05,0.24 ＋ 0.03, （6.45 ± 2.45 ）pmol/L, （6.35 ± 2.88 ）pg/L, （ 18.55± 2.58 ）pg/L] before therapy. The CD3, CD4, CDa, sIL-2R, IL-4 and TNF- ot were significantly changed in treatment group four and eight weeks after therapy compared with those before treatment. There were not changed in control group four weeks after therapy. But significantly difference showed eight weeks after therapy in control group, compared with those before treatment. Conclu- sion As an immunomodulator,the aerosohzing inhalation of rhIFN-γ to treat patients with retreatment MDR-PT can obviously improve immunological function of body.
出处
《中国医师进修杂志（内科版）》
2008年第1期21-23,共3页
Chinese Journal of Postgraduates of Medicine
基金
青岛市医药科研计划项目（2005-wszd049）
关键词
结核
肺
耐多药
干扰素-Γ
重组
T淋巴细胞
细胞因子
Tuberculosis,pulmonary
Multi-drug resistance
Interferon-gamma,recombinant
T lymphocytes
Cytokine
