胸腺五肽联合2HRZE/4HR方案治疗初治肺结核的临床效果及对肺功能和免疫功能的影响

Clinical Efficacy of Thymopetidum Combined with 2HRZE/4HR Regimen in Initial Treatment of Patients with Pulmonary Tuberculosis and Its Effects on Pulmonary Function and Immune Function

目的探讨胸腺五肽联合2HRZE/4HR方案治疗初治肺结核的临床效果及对肺功能和免疫功能的影响。方法选取2016年2月—2017年4月收治的88例初治肺结核患者,根据治疗方案不同将患者分为对照组和观察组,每组44例。对照组采用2HRZE/4HR方案治疗,观察组采用胸腺五肽联合2HRZE/4HR方案治疗。比较两组临床疗效、治疗前后肺功能、T淋巴细胞亚群和免疫球蛋白水平变化情况,并记录不良反应发生情况。结果治疗2、4和6个月后,对照组痰菌转阴率明显低于观察组(P<0.05)。治疗6个月后,观察组病灶吸收情况明显优于对照组(P<0.05)。治疗后,两组用力肺活量、最大呼气峰流速百分比和第1秒用力呼气容积水平高于治疗前,观察组高于对照组(P<0.05)。治疗后,两组CD3+、CD8+水平升高,CD4+水平降低(P<0.05);且观察组上述指标变化幅度高于对照组(P<0.05)。两组治疗前后以及组间Ig G、Ig M、Ig A水平比较差异无统计学意义(P>0.05),且两组不良反应总发生率比较差异无统计学意义(P>0.05)。结论胸腺五肽联合2HRZE/4HR方案治疗初治肺结核临床效果显著,可有效改善患者肺功能、T淋巴细胞亚群及免疫球蛋白水平。

Objective To investigate clinical efficacy of Thymopetidum combined with 2hrze/4hr regimen in initial treatment of patients with pulmonary tuberculosis and its effects on pulmonary function and immune function. Methods A total of 88 initially treated patients with pulmonary tuberculosis admitted during February 2016 and April 2017 were divided into control group and observation group （ n =44 for each group） according to different treatment regimens. Control group was treated with 2HRZE/4HR regimen, while observation group was treated with Thymopetidum combined with 2hrze/4hr regimen. Clinical efficacy, changes of pulmonary function, T lymphocyte subsets and immunoglobulin levels before and after treatment were compared, and incidence rates of adverse reactions were recorded in two groups. Results After treatment for 2, 4 and 6 months, sputum negative conversion rates in control group were significantly lower than those in observation group （ P 〈0.05）. After treatment for 6 months, absorption condition of lesions in observation group was significantly better than that in control group （ P 〈0.05）. After treatment, values of forced vital capacity, the maximum peak expiratory flow percentage and the first second forced expiratory volume were significantly increased compared with those before treatment in two groups, and the change values in observation group were significantly larger than those in control group （ P 〈 0.05）. After treatment, CD3＋ and CD8＋ levels were increased, while CD4＋ levels were decreased in two groups （ P 〈0.05）, and the change values in observation group were larger than those in control group （ P 〈0.05）. There were no significant differences in IgG, IgM and IgA levels before and after treatment and between two groups （ P 〉0.05）, and there was also no significant difference in the total incidence rate of adverse reactions between two groups （ P 〉0.05）. Conclusion Thymopetidum combined with 2hrze/4hr regimen in initial treatment of patients with pulmonary tuberculosis may achieve good clinical efficacy and effectively improve pulmonary function, T lymphocyte subgroup and immunoglobulin levels.