青海地区高剂量、长疗效标准化治疗肺结核的疗效及对患者免疫系统、细胞因子的影响

The Efficacy of High-dose,Long-term Standardized Treatment for Pulmonary Tuberculosis in Qinghai Region and its Impact on Patients'Immune System and Cytokines

目的:探讨青海地区高剂量、长疗效标准化治疗肺结核患者的临床效果及对其免疫系统、细胞因子的影响。方法:收集2019年7月—2021年7月在我院接受治疗的肺结核患者80例,将其随机分为观察组和对照组各40例。对照组予以短程间歇化治疗,观察组予以高剂量、长疗效标准化治疗方案,观察并比较两组患者的临床疗效、不良反应发生情况及治疗前后炎症因子水平和免疫功能。结果:(1)治疗后,观察组治疗总有效率为95.00%,高于对照组(P<0.05)。(2)治疗后,两组患者白介素6(IL-6)、肿瘤坏死因子-α(TNF-α)水平均低于治疗前,且观察组IL-6水平为(2.24±0.87)μmol/L、TNF-α水平为(8.72±3.47)μmol/L,均低于对照组(P<0.05)。(3)治疗后,两组患者CD4+、CD4+/CD8+水平均高于治疗前,且观察组CD4+水平为(41.29±6.53)%、CD4+/CD8+水平为2.39±0.43,均高于对照组(P<0.05);两组患者调节性T细胞(Treg)水平低于治疗前,观察组Treg水平(2.89±0.81)%,低于对照组(P<0.05);观察组CD8+水平为(16.23±4.13)%,对照组CD8+水平为(16.52±4.61)%,两组比较,差异无统计学意义(P>0.05)。(4)观察组不良反应发生率为5.00%,低于对照组(P<0.05)。结论:应用高剂量、长疗效标准化治疗方案治疗青海地区肺结核患者,临床治疗效果明显,具有较好的抗炎效果,可提高患者免疫功能,且不良反应较少,值得临床推广应用。

Objective:The purpose of this study is to explore the clinical efficacy of high-dose,long-term standardized treatment for tuberculosis patients in Qinghai region and its impact on their immune system and cytokines.Methods:80 patients with pulmonary tuberculosis who were received treatment in our hospital from July 2019 to July 2021 were collected and randomly divided into an observation group and a control group,with 40 patients in each group.The control group received short-term intermittent treatment,while the observation group received high-dose,long-term standardized treatment.The clinical efficacy,incidence of adverse reactions,levels of inflammatory factors,and immune function before and after treatment were observed and compared between the two groups of patients.Results:After treatment,the total effective rate of the observation group was 95.00%,which was higher than that of the control group(P<0.05).After treatment,the levels of interleukin-6(IL-6)and tumor necrosis factor alpha(TNF-α)in both groups of patients were lower than before treatment,and the IL-6 level in the observation group was(2.24±0.87)μmol/L and the TNF-αlevel was(8.72±3.47)μmol/L,both lower than the control group(P<0.05).After treatment,the CD4+and CD4+/CD8+levels in both groups were higher than before treatment.The CD4+level in the observation group was(41.29±6.53)%,and the CD4+/CD8+level was 2.39±0.43,both higher than those in the control group(P<0.05).The levels of regulatory T cells(Treg)in both groups were lower than before treatment.The Treg level in the observation group was(2.89±0.81)%,which was lower than that in the control group(P<0.05).The observation group had a CD8+level of(16.23±4.13)%,while the control group had a CD8+level of(16.52±4.61)%.There was no statistically significant difference between the two groups(P>0.05).The incidence of adverse reactions in the observation group was 5.00%,which was lower than that in the control group(P<0.05).Conclusion:The standardized treatment plan with high dose and long efficacy in Qinghai region has significant clinical treatment effects,which is and good anti-inflammatory effects,which can improve patients'immune function,and has fewer adverse reactions,worthy of clinical promotion and application.