对氨基水杨酸异烟肼与异烟肼对复治性肺结核结核感染T细胞斑点试验结果的影响

The tuberculosis retreatment for TB infection with T cells spot test with aminosalicylate isoniazid and isoniazid

目的探讨对氨基水杨酸异烟肼与异烟肼对复治性肺结核结核感染T细胞斑点试验结果的影响。方法选择2010年1月~2014年1月我院收治的复治性结核病患者80例,按照随机数字表法分为两组,各40例,观察组使用对氨基水杨酸异烟肼、利福平、乙胺丁醇、吡嗪酰胺,连续治疗9个月为一个疗程;对照组使用异烟肼、利福平、乙胺丁醇、吡嗪酰胺,连续治疗9个月为一个疗程,根据患者治疗过程中肝肾功能及全身情况,辅助给予肌苷片、复合维生素等保肝护肝药物,并进行对症支持治疗。结果两组治疗前IFN-γ水平差异无统计学意义（P〉0.05）,治疗后观察组IFN-γ水平低于对照组及治疗前（P〈0.05）,观察组CD4＋水平高于对照组（P〈0.05）,CD8＋水平低于对照组（P〈0.05）,CD4＋/CD8＋比值低于对照组（P〈0.05）,两组干预前结核感染T细胞斑点试验均为阳性,治疗后观察组结核感染T细胞斑点试验阳性率显著低于对照组（P〈0.05）。结论对氨基水杨酸异烟肼治疗复治性肺结核能更好地调节患者机体免疫力,降低结核感染T细胞斑点试验阳性率,值得临床推广。

Objective To investigate the effect of tuberculosis retreatment for TB infection with T cells spot test with aminosalicylate isoniazid and isoniazid. Methods All 80 patients were choosed and previously treated with TB from January 2010 to January 2014 in our hospital,all were divided into two groups randomly, each 40 cases ,the observa- tion group was used aminosalicylate isoniazid, rifampicin, ethambutol, pyrazinamide,all were treated with nine-month continuous course, the control group was used isoniazid,rifampicin, ethambutol,pyrazinamide, all were treatmented with nine-month continuous course also,then liver and kidney function and general condition,aid granted inosine tablets,vitamin and other hepatoprotective drug were compared with the two groups. Results Before treatment, the IFN-γlevels had no significant difference between the two groups（P〉0.05）, IFN-γlevel in the observation group was less than control group and before treatment （P〈0.05）, CD4^＋ level was higher than control group（P〈0.05）, CD8＋ levels was lower than control group（P〈0.05）, CD4^＋/CD8^＋ ratio was lower than control group（P〈0.05）, the positive rate with TB infection rate spot T cells post-treatment with the observation group was significantly lower than control group （P〈 0.05）. Conclusion The aminosalicylate isoniazid for tuberculosis retreatment for TB infection can better regulate immu- nity and reduce tuberculosis infection rate with test positive T cells spot, so it is worthy of promotion.