摘要
目的探讨纤维支气管镜介入辅助治疗对耐多药肺结核(multi drug resistant pulmonary tuberculosis,MDR-TB)病人病情及痰菌转阴率的影响。方法 2013年12月~2017年8月间在某院接受治疗的耐多药肺结核病人82例,回顾性分析其治疗方案并分为:对照组(n=43、接受常规抗结核化疗)、研究组(n=39、接受纤维支气管镜介入联合抗结核化疗)。治疗6月后观察两组病人的治疗效果及外周血T淋巴细胞亚群分布、血清炎症因子含量情况,记录痰菌转阴率。结果治疗6月后,研究组病人的病灶吸收率为89. 74%,高于对照组病人的69. 77%(P <0. 05);研究组外周血中CD4^+T淋巴细胞比例及CD4^+/CD8^+比值均高于对照组,CD8^+T淋巴细胞比例低于对照组(P <0. 05);血清中炎症因子白介素-12(IL-12)、干扰素γ(IFN-γ)、C反应蛋白(CRP)的含量低于对照组(P <0. 05);研究组痰菌转阴率为53. 85%,高于对照组的30. 23%(P <0. 05)。结论 MDR-TB病人在抗结核化疗基础上加入纤维支气管镜介入治疗,可有效提升治疗效果并优化机体免疫、炎症状态,最终增加痰菌转阴率。
Objective To investigate the effect of fiberoptic bronchoscope intervention therapy on the condition of patients with multi drug resistant pulmonary tuberculosis( MDR-TB) and sputum negative conversion. Methods There are 82 patients with MDR-TB who were treated in a hospital from December 2013 to August 2017 were retrospectively analyzed and divided into control group( n = 43,receiving routine anti-tuberculosis chemotherapy) and study group( n = 39,receiving fiberoptic bronchoscope intervention combined with anti-tuberculosis chemotherapy). After 6 months of treatment,the therapeutic effects of the two groups of patients,distribution of T lymphocyte subsets in peripheral blood and serum inflammatory factors were observed,and the rate of sputum negative conversion was recorded. Results After 6 months of treatment,the lesion absorption rate of the study group was 89. 74%,which was higher than 69. 77% of the control group( P < 0. 05). The proportion of CD4^+T lymphocytes and the ratio of CD4^+/CD8^+in peripheral blood of the study group were higher than those of the control group,and the proportion of CD8^+T lymphocytes was lower than that of the control group( P < 0. 05). The serum levels of inflammatory factors interleukin-12( IL-12),interferon gamma( IFN-γ) and C-reactive protein( CRP) in the study group were lower than those in the control group( P < 0. 05). The sputum negative conversion rate in study group was 53. 85%,which was higher than 30. 23% in control group( P < 0. 05). Conclusion Treating MDR-TB with fiberoptic bronchoscope intervention on the basis of anti-tuberculosis chemotherapy can effectively improve the therapeutic effect and optimize the body’ s immune and inflammatory status,and ultimately increase the rate of sputum negative conversion.
作者
刘德平
陈慧冬
刘黎
杨金边
石应元
刘德军
LIU Deping;CHEN Huidong;LIU Li;YANG Jinbian;SHI Yingyuan;LIU Dejun(Wuhan Infectious Disease Hospital,Hubei 430022,China;不详)
出处
《医学动物防制》
2020年第1期18-21,共4页
Journal of Medical Pest Control
基金
武汉市卫生与计划生育委员会科研基金资助项目(WZ17B09).
关键词
耐多药肺结核
纤维支气管镜
T淋巴细胞亚群
炎症反应
痰菌转阴率
Multi drug resistant pulmonary tuberculosis
Fiberoptic bronchoscopy
T lymphocyte subsets
Inflammatory response
Sputum negative conversion rate
作者简介
刘德平(1962-),男,副主任医师,研究方向:结核病及其疾病的治疗;通讯作者:刘德军,E-mail:tb4300@163.com
