卡介菌多糖核酸对早期梅毒血清固定患者相关免疫指标的影响及临床疗效分析研究

Clinical study of BCG polysaccharide nucleic acid to the immune indicators of the early syphilis sero-resistant patients

目的观察免疫增强剂卡介菌多糖核酸对早期梅毒血清固定患者的疗效及血清相关免疫因子的影响,初步探讨卡介菌多糖核酸治疗梅毒血清固定的可能免疫调节机制。方法对我院确诊的梅毒血清固定患者随机分为治疗组与对照组,对照组予以头孢曲松钠每日1.0静脉注射共14 d治疗,治疗组在应用头孢曲松钠治疗的基础上同时辅以卡介菌多糖核酸0.70 mg隔日肌注共20次治疗,治疗结束按时随访至12月时,计算两组的痊愈率;ELISA法观察两组治疗前后血清Th1淋巴细胞分泌的细胞因子IL-2、Th2淋巴细胞分泌的细胞因子IL-10的变化情况;应用t检验及方差分析对结果进行统计学分析。结果①治疗结束后,按规定时间随访12个月,治疗组痊愈率85.0%,对照组痊愈率75.0%,两组差异无显著性(χ2=0.156,P>0.05);②治疗前,两组IL-2的水平明显低于正常组、IL-10的水平明显高于正常组,均具有统计学差异(P均<0.05)。治疗后,治疗组IL-2的水平较治疗前明显提高(P<0.05),而与正常组水平相当(P>0.05);IL-10的水平较治疗前明显降低(P<0.05),而与正常组水平相当(P>0.05)。治疗后,对照组IL-2的水平较治疗前明显提高(P<0.05),但仍低于正常组(P<0.05);IL-10的水平较治疗前明显降低(P<0.05),但仍高于正常组(P<0.05)。结论梅毒血清固定患者应用头孢曲松钠驱梅治疗疗效确切,若同时辅以免疫增强剂卡介菌多糖核酸治疗,可提高患者的免疫力维持Thl/Th2比值的动态平衡,恢复正常的免疫功能。

[ Objective ] By observing the therapeutic efficacy and the impact to the serum immune factors of BCG polysaccharide nucleic acid, a immunostimulant, to early syphilis sero-resistant patients, we were trying to investi- gate the relative possible immunomodulatory mechanism. [ Methods ] Syphilis sero-resistant patients diagnosed and identified in our hospital were randomly divided into the treatment group and the control group. The control group received a daily intravenous injection of 1.0 Ceftriaxone sodium for 14 days. In addition to the above Ceftriaxone sodium injection, the treatment group received an intramuscular injection of 0.70 mg of BCG polysaccharide nucleic acid every other day for 20 times. After the whole therapy the regular follow-up was conducted for 12 months. Therecovery rates of the two groups were respectively calculated. The changes of cytokines IL-2 and cytokine IL-10 re- spectively secreted by Thl lymphocytes and Th2 lymphocytes were observed before and after treatment. The results were analyzed using t test and variance analysis. [Results] After treatment and follow-up, the recovery rates of the treatment group and the control group are 85.0% and 75.0%. The difference was not statistically significant （X^2= 0.156, P 〉0.05）; Before treatment, the levels of IL-2 level of two groups were significantly lower than that of the nor- mal value （P 〈0.05）, and the levels of IL-10 were significantly higher than the normal value （P 〈0.05）. After treat- ment, the level of IL-2 in the treatment group was significantly improved versus before treatment （P 〈0.05） and com- parable to the level of the normal value （P 〉0.05）; the level of IL-10 was significantly decreased than before （P 〈 0.05） and comparable to the level of the normal value （P 〉0.05）. After treatment, the level of IL-2 in the control group was significantly improved versus before treatment （P 〈0.05） but still lower than the normal value （P 〈0.05）; the level of IL-10 was significantly decreased than before （P 〈0.05） but still higher than the normal group （P 〈0.05）. [ Conclusions ] The antisyphilitic therapeutic efficacy of Ceftriaxone sodium to syphilis sero-resistant patients has been validated. If this therapy was supplemented by the immunostimulant, BCG polysaccharide nucleic acid, it can improve the patient＇s immune system to maintain the dynamic equilibrium between Thl/Th2 and to restore normal im- mune function.