摘要
目的探讨环丝氨酸联合胸腺肽对耐多药肺结核患者治疗效果及生化指标的影响。方法选取2013年1月-2016年1月在医院接受治疗的耐多药肺结核患者82例,随机分为试验组和对照组,每组41例。对照组采用标准化治疗方案进行治疗,试验组在对照组的基础上采取环丝氨酸和胸腺肽联用进行治疗。比较两组患者治疗不同时期痰菌转阴率、病灶吸收率、空洞缩小率、T细胞亚群(CD4+、CD8+、CD4+/CD8+)水平、血清C-反应蛋白(CRP)、血清γ-干扰素(IFN-γ)和不良反应发生率。结果治疗12个月和治疗24个月后试验组痰菌转阴率、病灶吸收率、空洞缩小率均高于对照组(P<0.05);治疗12个月后试验组CD4+、CD4+/CD8+水平均高于对照组,CD8+水平低于对照组(P<0.05);血清CRP水平低于对照组,IFN-γ水平高于对照组(P<0.05);两组患者均发生胃肠道反应、轻微头痛、轻微肝功能损伤等不良反应。结论环丝氨酸联合胸腺肽治疗耐多药肺结核患者,疗效确切,同时提高患者的免疫功能,抑制机体的炎症反应,且安全性较好。
OBJECTIVE To explore the effect of cycloserine combined with thymosin on treatment of patients with multidrug-resistant tuberculosis and influence on biochemical indexes.METHODS A total of 82 patients with multidrug-resistant tuberculosis who were treated in the hospital from Jan 2013 to Jan 2016 were enrolled in the study and randomly divided into the experimental group and the control group,with 41 cases in each group.The control group was treated with standard treatment program,while the experimental group was given cycloserine combined with thymosin on basis of the treatment of the control group.The negative rate of sputum culture,rate of absorption of lesions,rate of reduction of cavity,levels of T cell subsets(CD4+,CD8+,CD4+/CD8+),serum C-reactive protein(CRP),serum interferon-γ(IFN-γ)and incidence of adverse reactions were observed and compared between the two groups of patients.RESULTS The negative rate of sputum culture,rate of absorption of lesions and rate of reduction of cavity were significantly higher in the experimental group than in the control group after the treatment for 12 and 24 months(P<0.05).The levels of CD4+and CD4+/CD8+of the experimental group were significantly higher than those of the control group after the treatment for 12 months,while the CD8+level of the experimental group was significantly lower than that of the control group(P<0.05).The serum CRP level of the experimental group was significantly lower than that of the control group,and the IFN-γlevel of the experimental group was significantly higher than that of the control group(P<0.05).Both groups of patients had adverse reactions such as gastrointestinal tract reactions,mild headache and mild liver function damage.CONCLUSION Cycloserine combined with thymosin can achieve remarkable effect on treatment of the patients with multidrug-resistant tuberculosis,boost the immune function of the patients and inhibit the inflammatory response,with the safety high.
作者
陈永宏
向江琳
肖江峰
陈瑞华
CHEN Yong-hong;XIANG Jiang-lin;XIAO Jiang-feng;CHEN Rui-hua(Yu′an Branch of Chongqing Three Gorges Central Hospital,Chongqing404100,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2019年第17期2643-2647,共5页
Chinese Journal of Nosocomiology
基金
重庆市卫生和计划生育委员会医学科研基金资助项目(2015MSX263)
关键词
耐多药肺结核
环丝氨酸
胸腺肽
疗效
免疫功能
不良反应
Multidrug-resistant tuberculosis
Cycloserine
Thymosin
Curative effect
Immune function
Adverse reaction
