经支气管镜灌注治疗联合常规化疗用于耐多药肺结核的疗效评估

Curative effect of transbronchoscopic perfusion combined with conventional chemotherapy for multi-drug resistant tuberculosis

目的:分析经支气管镜灌注治疗联合常规化疗用于耐多药肺结核的疗效。方法:选择2012年4月~2015年4月在本院接受治疗的70例耐多药肺结核患者并随机分为两组(n=35),对照组患者接受常规化疗,观察组患者接受经支气管镜灌注^+常规化疗。治疗后,对比两组患者痰菌转阴率、免疫功能、病情特异性指标、氧化应激指标、肝功能指标。结果:治疗6、12个月后,观察组患者的痰菌转阴率均显著高于对照组患者;治疗12个月后,观察组患者外周血中CD3^+、CD4^+、CD4^+/CD8^+、IgA、IgM、IgG水平均显著高于对照组患者,血清病情特异性指标ADA、LDH含量低于对照组患者;血清氧化应激指标TOS、MAOA、OSI含量低于对照组患者,TAS、GSH-Px含量高于对照组患者;血清肝功能指标STB、ALP、ALT、AST含量低于对照组患者,TP含量高于对照组患者。差异均具有统计学意义(P<0.05)。结论:经支气管镜灌注治疗联合常规化疗可提升耐多药肺结核患者的治疗有效性、改善免疫功能、减轻氧化应激及肝损伤,在优化远期治疗结局方面具有优势。

Objective：To analyze the curative effect of transbronchoscopic perfusion combined with conventional chemotherapy for multi-drug resistant tuberculosis.Methods：A total of 70 patients with multi-drug resistant tuberculosis treated in our hospital were selected and randomly divided into two groups（n=35）.Control group received conventional chemotherapy and observation group received transbronchoscopic perfusion-＋ conventional chemotherapy.After treatment,negative conversion ratio of sputum mycobacterium tuberculosis,immune function,disease-specific indexes,oxidative stress indexes and liver function indexes were compared between two groups of patients.Results：After 6months and 12 months of treatment,negative conversion ratio of sputum mycobacterium tuberculosis of observation group were significantly higher than those of control group;after 12 months of treatment,CD3^＋,CD4^＋,CD4^＋CD8^＋,IgA,IgM and IgG levels in peripheral blood of observation group were significantly higher than those of control group while disease-specific indexes ADA and LDH content in serum were lower than those of control group;oxidative stress indexes TOS,MAOA and OSI content in serum were lower than those of control group while TAS and GSH-Px content were higher than those of control group;liver function indexes STB,ALP,ALTand AST content in serum were lower than those of control group while TP content was higher than that of control group.Conclusion：Transbronchoscopic perfusion combined with conventional chemotherapy can improve the treatment effectiveness,improve immune function as well as reduce oxidative stress and liver damage in patients with multi-drug resistant tuberculosis,and is advantageous in optimizing long-term treatment outcome.