摘要
目的 探讨地塞米松联合尿激酶及标准抗结核治疗结核性胸膜炎的临床疗效。方法 选择2016年1月至2017年3月本院收治的结核性胸膜炎患者96例,将其按随机对照原则分为两组,各48例。对照组给予标准抗结核治疗+尿激酶治疗,观察组在对照组基础上,给予地塞米松治疗。比较两组临床疗效、症状改善情况、炎性因子水平及肺功能指标。结果 观察组总有效率高于对照组(89.58%比72.92%),差异有统计学意义(P<0.05);治疗后,观察组胸水总排出量[(3 486.34±368.14)ml]高于对照组[(2 964.71±324.96)ml],胸水消失时间[(12.61±3.63)d]低于对照组[(18.26±2.57)d],胸膜厚度[(1.36±0.57)mm]低于对照组[(1.85±0.68)mm],抽液次数[(3.42±1.18)次]低于对照组[(4.68±1.21)次],差异有统计学意义(P<0.05);治疗1个月后,观察组第1秒用力呼气量(FEV1)[(90.34±2.68)%]高于对照组[(84.58±2.31)%],用力肺活量(FVC)[(95.24±2.17)%]高于对照组[(87.36±3.12)%],白介素-6(IL-6)([138.64±35.31)pg/ml]低于对照组([223.41±51.26)pg/ml],白介素-8(IL-8)([228.34±72.15)pg/ml]低于对照组[(412.39±124.33)pg/ml],超敏C反应蛋白(hs-CRP)[(25.69±11.47)mg/L]低于对照组[(35.41±12.52)mg/L],差异均有统计学意义(均P<0.05)。结论地塞米松联合尿激酶治疗结核性胸膜炎,能促进患者症状恢复,降低患者炎性因子水平,改善肺功能,提高临床疗效,值得临床推广。
Objective To investigate the clinical efficacy of dexamethasone combined with urokinase and standard anti-tuberculosis therapy in the treatment of tuberculous pleuritis.Methods 96 patients with tuberculous pleuritis in our hospital from January 2016 to March 2017 were selected,and were divided into two groups according to randomized controlled method,with 48 cases in each group.Control group was given standard antituberculosis therapy and urokinase,while observation group was treated with dexamethasone based on control group.The clinical efficacy,improvement of symptoms,inflammatory factors,and pulmonary function indexes were compared between the two groups.Results The total effective rate of observation group(89.58%)was higher than that of control group(72.92%)(P<0.05).After treatment,the total pleural fluid output of observation group[(3 486.34±368.14)ml]was higher than that of control group[(2 964.71±324.96)ml],the disappearance time of pleural fluid of observation group[(12.61±3.63)d]was shorter than that of control group[(18.26±2.57)d],the pleural thickness of observation group[(1.36±0.57)mm]was less than that of control group[(1.85±0.68)mm],the times of fluid drained in observation group[(3.42±1.18)times]was lower than that in control group[(4.68±1.21)times](P<0.05).After treatment for 1 months,the forced expiratory volume in the first second(FEV1)in observation group[(90.34±2.68)%]was higher than that in control group[(84.58±2.31)%],the forced vital capacity(FVC)in observation group[(95.24±2.17)%]was higher than that in control group[(87.36±3.12)%],the level of interleukin-6(IL-6)in observation group[(138.64±35.31)pg/ml]was lower than that in control group[(223.41±51.26)pg/ml],the level of IL-8 in observation group[(228.34±72.15)pg/ml]was lower than that in control group[(412.39±124.33)pg/ml],the level of high-sensitivity C-reactive protein(hs-CRP)in observation group[(25.69±11.47)mg/L]was lower than that in control group[(35.41±12.52)mg/L](P<0.05).Conclusion Dexamethasone combined with urokinase in the treatment of tuberculous pleuritis can promote recovery of symptoms,decrease the levels of inflammatory factors,improve pulmonary function,and increase clinical efficacy,which is worthy of clinical promotion.
作者
吴艳玲
Wu Yanling(Tuberculosis Control Institute in Zhumadian City,Zhumadian 463000,China)
出处
《国际医药卫生导报》
2018年第23期3632-3635,共4页
International Medicine and Health Guidance News
关键词
结核性胸膜炎
地塞米松
尿激酶
临床疗效
炎性因子
肺功能
Tuberculous pleuritis
Dexamethasone
Urokinase
Clinical efficacy
Inflammatory factors
Pulmonary function
