研究分析胸腔注射糖皮质激素治疗结核性胸膜炎的疗效及对炎症细胞因子的影响

Study on efficacy of chest corticosteroid injection in the treatment of tuberculous pleurisy and its influence on in-flammatory cytokines

目的：对比分析胸腔注射和口服糖皮质激素两种治疗方案治疗结核性胸膜炎的临床效果及对炎症因子的影响。方法从河南省某医院选取64例结核性胸膜炎患者，随机分为两组，试验组采用胸腔注射糖皮质激素治疗，对照组采用口服糖皮质激素治疗，观测两组患者临床效果及用药前后炎症细胞因子变化。结果试验组治疗总有效率为96．88%，对照组为75．00%，差异有统计学意义（ P〈0．05）；用药后第9天对照组与试验组白细胞介素-6（IL-6）水平[（291．00±77．70）pg/ml VS （79．24±18．93）pg/ml]比较差异有统计学意义（P〈0．05）；IL-8水平[（616．74±169．51）pg/ml VS （178．00±71．50）pg/ml]比较差异有统计学意义（P〈0．05）；IL-18水平[（1143．49±136．88）pg/ml VS （1166．00±148．54）pg/ml]比较差异未见统计学意义（P〉0．05）。结论胸腔注射糖皮质激素治疗结核性胸膜炎，可使药物直接作用于胸腔，更好的实现对炎症细胞因子的控制，促使胸腔积液快速吸收，帮助临床治疗效果得到提升，是一种值得推广的治疗方案。

Objective To compare the effect of intrapleural injection of glucocorticoid in the treatment of tubercu-lous pleurisy and analyse the influence on inflammatory cytokines. Methods Sixty-four tuberculous pleurisy patients were selected, they were randomly divided into two groups：experimental group with chest injection of glucocorticoid treatment, control group treated with oral glucocorticoids, clinical effect and changes of inflammatory cytokines of the two groups were observed before and after medication. Results The total effective rate of experimental group was 96. 88%, and 75. 00% of control group, the difference was significant （P〈0. 05）. At the ninth day after medication,the IL-6 level was （291. 00 ± 77. 70）pg/ml in experimental group and （79. 24 ± 18. 93）pg/ml in control group（P〈0. 05）;the IL-8 level was （616. 74 ± 169. 51） pg/ml in experimental group and （ 178. 00 ± 71. 50 ） pg/ml in control group （ P 〈0. 05 ）; the IL-18 level was （1143.49 ±136.88）pg/ml in experimental group and （1166.00 ±148.54）pg/ml in control group（P〉0.05）. Conclu-sions Intrapleural injection of glucocorticoid in the treatment of tuberculous pleurisy, can make the drug directly ACTS on the chest, better realize the control of inflammatory cytokines, encourage pleural effusion absorption, improve the clinical treatment effect, is worth promoting.