支气管镜辅助治疗肺结核临床疗效及对细胞免疫水平影响

Effects of bronchoscope in aided treatment of TB and impacts on cell immunity level

目的探究支气管镜下注射辅助治疗肺结核的临床疗效及对细胞免疫功能的影响。方法选择医院收治的64例肺结核患者,随机分为两组,对照组给予标准化疗药物治疗;观察组在对照组基础上,加用支气管镜下注射给药治疗。比较两组治疗2和6个月时的痰菌转阴率,以及治疗前及治疗后2个月的肺泡灌洗液中腺苷脱氨酶(ADA)、乳酸脱氢酶(LDH)水平、肺功能及免疫水平。结果不同治疗阶段,观察组的痰菌转阴率均显著高于对照组(P<0.05);治疗后两组的ADA和LDH水平明显下降,且观察组明显低于对照组(P<0.05);两组FEV1、FVC以及FEV1/FVC水平明显上升(P<0.05),且观察组明显高于对照组(P<0.05);治疗后,对照组的细胞免疫水平无明显改善,但观察组的CD3+、CD4+以及CD4+/CD8+水平与治疗前相比均明显提升,CD8+水平显著下降(P<0.05)。结论支气管镜下注射化疗药物可显著提高肺结核的临床疗效,改善肺功能,并有助于调节机体细胞免疫机能,增强抗结核能力,值得临床推广。

Objective To explore the effects of bronchoscope in aided treatment of tuberculosis （TB） and impacts on cellular immune function. Methods A total of 64 patients with TB to receive treatment in our hospital were selected and randomly divided into a control group and an observation group （n=32, respectively）. The control group was treated with standard chemotherapy drugs and the observation group additionally treated with parenteral administration under bronchofiberscopy. The sputum negative conversion rates two and six months after the treatment and the levels of adenosine deaminase （ADA） and lactic dehydrogenase（LDH） in the bronchoalveolar lavage fluid two months after the treatment, pulmonary function （PF） and immune level between the two groups were compared. Results The sputum negative conversion rates in the observation group were significantly higher than those in the control group at different treatment stages （P 〈 0.05）; the post-treatment ADA and LDH levels in the two groups decreased significantly, and the levels in the observation group were much lower than those in the control group （P 〈 0.05）; the FEV,, FVC and FEVI/FVC levels in the two groups increased greatly （P 〈 0.05）, and the levels in the observation group were much higher than those in the control group （P 〈 0.05）; after the treatment, the cellular immune level in the control group had no significant improvement, while the CD3＋, CD4＋ and CD4＋/CD8＋ levels in the observation group were much higher than those before the treatment but the levels of CD8 ＋ decreased greatly （P 〈 0.05）. Conclusion The injection of chemotherapeutics under bronchofiberscopy can significantly improve the effects in the treatment of TB and PF, and can help to regulate the immune function of body cells and enhance anti-TB capability, so it is worthy of clinical popularization.