化疗对肺结核病患者抗体水平的影响及相关因素探讨

Effect of chemotherapy on antibody levels in pulmonary tuberculosis and related factors

目的调查结核病患者化学药物治疗(化疗)后体液免疫反应特征,并探讨其影响因素。方法109例接受化疗的结核病患者,采用SPA-ABC ELISA每周检测其血清抗PPD和抗38KDa蛋白抗体滴度,至12周。结果结核病患者化疗后体液免疫反应可分为3种模式,模式1、模式2和模式3患者痰涂片阳性率分别为76.5%、92.6%和0%,其耐多药病例比率分别为11.8%、63.0%和0%。结论化疗后结核病患者体液免疫反应存在3种模式,但不同抗原的抗体应答模式特征不尽相同。病灶结核菌数量及其耐药性可能是导致化疗后不同体液免疫反应模式的重要因素。

Objective To investigate the characteristics of humoral immune response in tuberculosis patients under chemotherapy and the associated factors. Methods The antibody titres in the sera fiom 109 patients with pulmonary tuberculosis were assayed by SPA - ABC ELISA once a week during 12 weeks of treatment. Results Three modes of humoral immune response were found in the patients with tuberculosis after chemotherapy. The rates of smear - positive patients in mode 1, 2 and 3 were 76.5% ,92.6% and 0% , respectively. The rates of multidrug- resistance in those modes were 11.8% ,63% and 0%, respectively. Conclusions Three modes of humoral immune response exist in tuberculous patients receiving chcmotheray and are not the same for antibodies to different antigens. The different modes of antibody response are presunmably associated with the bacterial burden in focus and with the drug resistance of the tubercle bacilli.