抗结核感染免疫疗法治疗肺结核的疗效及对免疫功能和生活质量的影响

发布时间：2018-03-15 23:33

  本文选题：肺结核　切入点：肺功能　出处：《医学综述》2016年21期 　论文类型：期刊论文

【摘要】：目的探讨抗结核感染免疫疗法治疗肺结核的疗效及对免疫功能和生活质量的影响。方法回顾性分析2012年5月至2014年12月在华北石油管理局总医院治疗的70例结核分枝杆菌阳性的初治肺结核患者的临床资料,按照治疗方法不同分为对照组和观察组,各35例。对照组给予0.3 g异烟肼、1.5 g吡嗪酰胺、0.75 g乙胺丁醇口服,静脉滴注0.6 g利福平,每日1次。观察组在对照组基础上给予静脉滴注0.08 g胸腺五肽,每日1次。两组患者均治疗16周。观察两组患者的临床疗效,治疗前后的肺功能、免疫功能、炎性因子和生活质量。结果 (1)疗效:观察组阴转率为82.9%(29/35),对照组为71.4%(25/35),组间比较差异无统计意义(P0.05);观察组病灶吸收率为85.7%(30/35),对照组为82.9%(29/35),组间比较差异无统计意义(P0.05)。(2)肺功能:治疗后,观察组第一秒用力呼气量、第一秒用力呼气量占用力肺活量比值、用力呼气25%时瞬间流速、用力呼气50%时瞬间流速高于对照组[(1.92±0.32)L比(1.62±0.24)L,(74.31±2.13)%比(67.82±1.63)%,(73.82±11.33)L/s比(65.14±12.61)L/s,(80.21±9.73)L/s比(72.12±11.12)L/s],差异有统计学意义(P0.01)。(3)免疫功能:治疗后,观察组IgG高于对照组[(11.22±2.63)g/L比(9.73±2.74)g/L],IgE低于对照组[(107.92±56.24)ng/L比(223.53±34.82)ng/L],差异有统计学意义(P0.05)。(4)炎性因子:治疗后,观察组白细胞介素(IL)-6、IL-8、肿瘤坏死因子α低于对照组[(86.72±9.95)μg/L比(99.24±10.81)μg/L,(0.31±0.14)μg/L比(0.38±0.11)μg/L,(90.53±22.32)ng/L比(102.73±20.82)ng/L],差异有统计学意义(P0.05)。(5)生活质量:治疗后,观察组生活质量评分低于对照组[(16±6)分比(24±7)分],差异有统计学意义(P0.05)。结论抗结核感染免疫疗法治疗肺结核能明显缓解临床症状,改善患者肺功能和生活质量,提高机体免疫功能。
[Abstract]:Objective to investigate the effect of immunotherapy against tuberculosis infection on pulmonary tuberculosis and its effect on immune function and quality of life. Methods 70 cases of tuberculosis treated in the General Hospital of North China Petroleum Administration Bureau from May 2012 to December 2014 were retrospectively analyzed. Clinical data of Mycobacterium positive patients with Primary Pulmonary Tuberculosis, The control group was given 0.3 g isoniazid and 1.5 g pyrazinamide 0.75 g ethambutanol orally, and 0.6 g rifampicin was injected intravenously. The observation group received 0.08 g thymic pentapeptide intravenously once a day once a day. The patients in both groups were treated for 16 weeks. The clinical efficacy, lung function and immune function before and after treatment were observed. Inflammatory factors and quality of life. Results 1) curative effect: the negative conversion rate of the observation group was 82.9% / 35%, the control group was 71.4% / 35%, the difference between the two groups had no statistical significance (P0.05%), the focus absorption rate of the observation group was 85.7% 30 / 35%, the control group was 82.9% / 2935%, the difference between the two groups had no statistical significance (P 0.05%.) after treatment, the lung function of the observation group was 85.7% 30% 35%, and that of the control group was 82.9% 29% 35%. There was no statistical significance between the two groups in lung function: after treatment, In the observation group, the forced expiratory volume at 1 second, the ratio of forced expiratory volume to forced vital capacity at 1 second, and the instantaneous flow rate at 25 hours after forced exhalation, The instantaneous flow rate in the forced expiratory 50 was higher than that in the control group (1.92 卤0.32 L / L vs 1.62 卤0.24 L / L = 74.31 卤2.13% vs 67.82 卤1.63 L / s = 65.14 卤12.61 L / s vs 65.14 卤12.61 L / s / s = 72.12 卤11.12 L / s respectively). The IgG in the observation group was higher than that in the control group [11.22 卤2.63 g / L vs 9.73 卤2.74 g / L] and was lower than that in the control group [107.92 卤56.24 ng / L vs 223.53 卤34.82 ng / L]. IL-8, TNF- 伪 were significantly lower in the observation group than in the control group [86.72 卤9.95 渭 g / L vs 99.24 卤10.81 渭 g / L vs 0.31 卤0.14) 渭 g / L vs 0.38 卤0.11) 渭 g / L, 90.53 卤22.32 ng / L vs 102.73 卤20.82 ng / L, respectively. The quality of life score in the observation group was lower than that in the control group [16 卤6 vs 24 卤7], and the difference was statistically significant (P 0.05). Conclusion Immunotherapy with anti-tuberculosis infection can obviously relieve the clinical symptoms, improve the lung function and quality of life of the patients, and enhance the immune function of the body.
【作者单位】： 华北石油管理局总医院结核科;华北石油管理局总医院保健科;华北石油管理局总医院心内科;
【分类号】：R521
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