摘要
目的：观察糖皮质激素用于结核性胸膜炎的疗效分析及其对胸水炎症细胞因子表达水平的影响。方法选择2012年1月至2015年6月滨州市结核病防治院收治的193例结核性胸膜炎患者，将其分为对照组（95例）和研究组（98例），所有研究对象均给予抗结核药物治疗，其中研究组在此基础上给予胸腔注射地塞米松治疗，抽取两组患者不同治疗时间段的胸水并检测炎症细胞因子表达水平。结果研究组患者治疗有效者89例，无效9例，对照组患者有效74例，无效21例，两组患者疗效比较差异有统计学意义（P〈0.05）。研究组患者发热消退时间、胸腔积液消退时间、胸腔积液抽取量及并发胸膜肥厚的概率为（8.15±2.97）d、（10.94±2.85）d、（2562.32±245.35）ml、41.83%，均显著低于对照组的（17.31±2.65）d、（18.83±1.97）d、（5572.28±261.82）ml、82.11%，组间比较差异有统计学意义（P〈0.05）。两组患者治疗前炎症细胞因子IL-6、IL-8表达水平比较，差异无统计学意义（P〉0.05）。研究组患者经胸腔注射地塞米松治疗后第3、6、9天胸腔积液IL-6的表达水平显著低于对照组患者[（276.49±27.85）pg/ml vs（350.38±20.01）pg/ml，（195.32±14.35）pg/ml vs（312.51±14.82）pg/ml，（86.74±10.28）pg/ml vs（251.74±16.62）pg/ml]，差异有统计学意义（P〈0.05）；IL-8的表达水平也显著低于对照组患者[（576.51±19.79）pg/ml vs（850.64±27.70）pg/ml，（225.30±14.29）pg/ml vs（742.49±15.28） pg/ml，（127.68±11.23）pg/ml vs（443.47±12.63）pg/ml]，差异有统计学意义（P〈0.01）。结论胸腔注射糖皮质激素能够更好地直接作用于胸腔，实现对炎症细胞因子的控制，促进胸腔积液的吸收，能够获得较好的临床疗效，可以临床推广使用。
Objective To investigate the effects of glucocortieoid in patients with tuberculous pleuritis and its impact on the level of inflammatory cytokines IL-6 and IL-8. Methods From January 2012 to June 2015,193 patients with tuberculous pleuritis were divided into research group and control group by random digits table methodin the TB Prevention Hospital of Binzhou City.The patients in two groups were all given anti-TB medication,and the research group was also given chest injection of dexamethasone treatment on the basis of anti-TB medication treatment.The clinical efficacy and IL-6 and IL-8 level change was observed. Results 89 cases showed good effect,and 9 cases was invalid in research group and there were 74 and 21 cases in control group respectively,and there was significant difference between research group and control group （P〈0.05）.The fever subsidence time,pleural effusion subsidence time,pleural effusion drawing volume,and thickening of pleura in research group was less than that in control group [（8.15±2.97）d vs （17.31±2.65）d,（10.94±2.85）d vs （18.83±1.97）d,（2562.32±245.35）ml vs（5572.28±261.82）ml,41.83%vs 82.11%],and there was significant difference（P〈0.05）.There was no significant difference in inflammatory cytokines before treatment between two groups（P〉0.05）.The levels of inflammatory cytokines IL-6 level after treatment of 3,6 and 9 d in research group was lower than that in control group [（276.49±27.85） pg/ml vs （350.38±20.01） pg/ml,（195.32±14.35） pg/ml vs （312.51±14.82） pg/ml,（86.74±10.28） pg/ml vs （251.74±16.62） pg/ml,and there was significant difference（P〈0.05）.and IL-8 level[（576.51±19.79）pg/ml vs（850.64±27.70）pg/ml,（225.30±14.29）pg/ml vs（742.49±15.28） pg/ml,（127.68±11.23）pg/ml vs（443.47±12.63）pg/ml] Conclusions Intrapleural injection of glucocorticoid in the treatment of tuberculous pleurisy, can make the drug directly acts on the chest, better realize the control of inflammatory cytokines, encourage pleural effusion absorption, improve the clinical symptoms early. It is worthy of clinical apphcation.
出处
《中国临床实用医学》
2016年第2期27-30,共4页
China Clinical Practical Medicine
基金
滨州医学院校级科研计划与科研启动基金项目（BY2013KJ102）
关键词
糖皮质激素
结核性胸膜炎
炎症细胞因子
Ghcocorticoids
Tuberculous Pleurifis
Cell Inflammatory Cytokines
