胸腺肽α1辅助治疗对耐药肺结核患者免疫功能的影响

Effects of the treatment of Thymosin alpha1 on the immune function of patients with drug-resistant pulmonary tuberculosis

目的观察胸腺肽α1辅助治疗耐药肺结核的临床疗效及其对患者免疫功能(Th17/Treg)的影响。方法将64例耐药肺结核患者采用随机数字表法分为观察组和治疗组,每组各32例。两组均予西医抗结核药物治疗,总疗程为18个月;治疗组加予肌注胸腺肽α1针1.6 mg,2次/周,连续治疗3个月;另选健康体检者30名为对照组。比较分析观察组、治疗组的临床疗效和治疗前后两组肺部结核病灶吸收率、痰结核菌转阴率、外周血T淋巴细胞表达和药物不良反应等。结果 (1)观察组、治疗组的总有效率分别为56.7%和83.3%(P<0.05)。(2)治疗3、6个月,治疗组肺部结核病灶吸收率、痰结核菌转阴率均高于观察组,但两组治疗3个月差异无统计学意义(P>0.05)。(3)观察组和治疗组外周血Th17、Treg和Th17/Treg较对照组明显下降(P<0.01);治疗3、6个月,治疗组外周血Th17、Treg和Th17/Treg较治疗前明显升高(P<0.01),与观察组比较差异有统计学意义(P<0.05)。(4)观察组、治疗组不良反应发生率分别为26.6%和20.0%,差异无统计学意义(P>0.05)。结论胸腺肽α1辅助治疗耐药肺结核能提高临床疗效,有利于促进结核病灶吸收,增加患者的免疫功能,值得临床应用。

Objective To observe the clinical effects of the treatment of Thymosin alpha1 on drug resistant pulmonary tuberculosis, and its effects on the patients′immune function（ Th17/Treg） .Methods Sixty-four patients with drugresistant pulmonary tuberculosis were randomly divided into the observation group and the treatment group （32 cases in each group）.The two groups were treated with western medicine of antituberculosis drug for 18 months as a treatment course.Intramuscular injection of Thymosin alpha1 was added to the treatment group 1.6 mg per time, 2 times a week, consecutively for 3 months.30 healthy people were taken as the control group.The improvement of tuberculosis lesions, sputum negative conversion rate, peripheral blood T lymphocyte expression and the efficiency and drug adverse reactions were compared between the two groups before and after the treatment.Results （ 1 ） The total efficiency of the observation group and the treatment group were 56.7%and 83.3%（ P〈0.05 ） .（ 2 ） The im-provement of tuberculosis lesions and sputum negative rate of the treatment group were higher than those of the obser-vation group after 3 and 6 months of the treatment.（3） Th17, Treg and Th17/Treg in the peripheral blood of the two groups were decreased significantly compared with the control group（P〈0.01）.Th17, Treg and Th17/Treg in the peripheral blood of the treatment group were increased significantly after 3 and 6 the months of the treatment compared with those before the treatment（P〈0.01）.There was significant difference between the two groups（P〈0.05）.（4） The incidences of adverse reaction of the observation group and the treatment group were 26.6% and 20%（ P〉0.05 ） .Conclusion Thymosin alpha1 can increase the patients′immune function and improve the X-ray and clinical efficacy in treatment of drug resistant tuberculosis.