糖皮质激素治疗结核性胸膜炎的疗效及其对血清癌抗原125水平的影响

Effects of glucocorticoid in patients with tuberculous pleuritis and its impact on the level of serum cancer antigen 125

目的探讨糖皮质激素治疗结核性胸膜炎的疗效及其对血清癌抗原125水平的影响，以期为结核性胸膜炎治疗提供理论依据。方法160例结核性胸膜炎患者按随机数字表法分为治疗组和对照组，每组80例，两组均给予抗结核药物治疗，治疗组在此基础上给予泼尼松口服，观察两组患者临床疗效及血清癌抗原125水平变化情况。结果治疗组显效37例，有效35例，无效8例，对照组显效16例，有效45例，无效19例，两组疗效比较差异有统计学意义（p〈0．05）。治疗组患者发热消退时间、胸腔积液消退时间、胸腔积液抽取量及胸膜肥厚发生率明显优于对照组[（9．16±3．74）d比（15．54±0．97）d、（11．78±3．86）d比（16．78±3．50）d、（2345．64±321．75）ml比（3549．03±434．86）ml、40．00％（32／80）比80．00％（64／80）]，差异有统计学意义（P〈0．05）。两组患者治疗前血清癌抗原125水平比较差异无统计学意义（P〉0．05），治疗组患者治疗后7、14、30d血清癌抗原125水平明显低于对照组[（268．78±93．86）μg/L比（385．78±143．43）μg/L、（159．64±31．96）μg/L比（255．03±44．56）μg/L、（45．34±12．94）μg/L比（167．75±32．76）μg/L]，差异有统计学意义（P〈0．05）。结论糖皮质激素治疗结核性胸膜炎I临床疗效确切，能早期改善临床症状，值得临床推广应用。

Objective To investigate the effects of glucocorticoid in patients with tuberculous pleuritis and its impact on the level of serum cancer antigen 125 to provide theoretical basis for the treatment of tuberculous pleuritis. Methods One hundred and sixty patients with tuberculous pleuritis were divided into treatment group and control group with 80 cases each by random digits table method. The patients in two groups were given anti-TB medication, and the treatment group was given oral prednisone on the basis of anti-TB medication. The clinical efficacy and serum cancer antigen 125 level change was observed. Results Thirty-seven cases had excellent effect, 35 cases showed good effect,and 8 cases was invalid in treatment group and there were 16, 45 and 19 cases in control group respectively, and there was significant difference between two groups（P 〈 0.05）. The fever subsidence time, pleural effusion subsidence time, pleural effusion drawing volume, and thickening of pleura in treatment group was less than that in control group [（9.16 ± 3.74 ） d vs. （ 15.54± 0.97 ） d, （ 11.78 ± 3.86 ） d vs. （ 16.78 ± 3.50 ） d, （2345.64 ± 321.75 ） ml vs. （ 3549.03 ± 434.86） ml,40.00%（32/80） vs. 80.00%（64/80）],and there was significant difference （P〈0.05）. There was no significant difference in serum cancer antigen 125 before treatment between two groups （P 〉 0.05）. The levels of serum cancer antigen 125 after treatment of 7, 14 and 30 d in treatment group was lower than that in control group [ （268.78 ± 93.86） μg/L vs. （385.78 ± 143.43） μg/L, （ 159.64 ± 31.96）μg/L vs. （255.03 ±44.56）μg/L, （45.34 ±12.94） μg/L vs. （167.75 ± 32.76） μg/L],and there was significant difference （P 〈 0.05）. Conclusions The clinical efficacy of glueoeortieoid in treatment of tuberculous pleuritis can improve the clinical symptoms early. It is worthy of clinical application.