联用环丝氨酸治疗耐多药肺结核临床疗效及对免疫功能的影响

Clinical efficacy of combined therapy of multi drug resistant pulmonary tuberculosis and its effect on immune function

〔目的〕主要是通过联用环丝氨酸来治疗耐多药肺结核,观察临床疗效,探讨该药和免疫系统之间的关系。〔方法〕共102例患者,根据对照原则分为:实验组,52例;对照组,50例。采用标准MDR-TB的治疗方案,实验组加用环丝氨酸,对照组加用乙胺丁醇。〔结果〕从性别、肺野数、空洞数、耐药情况比较,实验组和对照组差别不大;痰细菌学阴转率,实验组65.3%,对照组62.0%,差异不大;X线检查病灶的有效率,实验组82.3%,对照组76.0%,有明显差异;空洞关闭率,实验组26.9%,对照组24.0%,无统计学上的差异;治疗后CD3+、CD4+、IFN-γ值明显升高,CD8+和IL-4值明显降低。〔结论〕联用环丝氨酸能在一定程度上使T淋巴细胞亚群得到调整,细胞免疫功能提高,该药治疗耐多药肺结核较为安全、有效。

〔O bjective〕To investigate the clinical effect of combined treatment of multi drug resistant pulmonary tuberculosis with serine, and the effect ofserine on the immune function.〔M ethods〕102 cases of multi drug resistant pulmonary tuberculosis patients were divided into treatment group（ 52 cases） and control group（ 50 cases） in which patients were treated with standard MDR-TB.Compared with the control group, Serine was added to the experimental group.〔R esults〕In the experimental group and the control group, there was no significant difference in sex, lung field number, cavity number and drug resistance. The sputum negative conversion rate of the experimental group was 65. 3%, and 62% in the control group. The result indicated that two groups were not statistically significant in the difference. By X-ray, the rate of the experimental group was 82. 3%, and the control group was76%, there was no significant difference between the two groups. After treatment, the cavity closure rate of the experimental group was 26. 9%, and the control group was 24%. There was no significant difference between the two groups. The value of CD3^＋,CD4^＋, IFNγwas significantly increased after treatment, and the values of CD8^＋and IL-4 were obviously decreased.〔C onclusion〕The T lymphocyte subsets can be adjusted to a certain extent by the combination of serine and the cellular immune function is improved. The drug is safe and effective in the treatment of multi drug resistant pulmonary tuberculosis.