纤维支气管镜药物灌注联合莫西沙星对耐多药肺结核患者痰菌转阴率及血清T细胞亚群、PCT水平变化的影响

Effect of Drug Perfusion Through Fiberoptic Bronchoscope Combined with Moxifloxacin on Sputum Negative Rate,Serum T Cell Subsets and PCT Level in Patients with Multidrug-resistant Tuberculosis

目的:探讨纤维支气管镜药物灌注联合莫西沙星对耐多药肺结核患者痰菌转阴率及血清T细胞亚群、PCT水平变化的影响。方法:选取2016年5月-2018年5月本院收治的耐多药肺结核患者98例。按照随机数字表法将其分为研究组和对照组,各49例。两组均接受常规治疗,在此基础上,对照组采用莫左氧氟沙星治疗,研究组在对照组基础上采用纤维支气管镜药物灌注联合莫西沙星治疗。比较两组痰菌转阴率、病灶吸收率、T细胞亚群(CD3^+、CD4^+、CD8^+)、血清降钙素原(PCT)、不良反应。结果:治疗6、9个月,研究组痰转阴率均高于对照组(P<0.05);研究组病灶总吸收率为89.8%,高于对照组的65.3%(P<0.05);治疗后,研究组T细胞亚群CD4^+、CD3^+水平高于对照组,PCT水平低于对照组,差异均有统计学意义(P<0.05),但两组T细胞亚群CD8+水平比较,差异无统计学意义(P>0.05);两组不良反应比较,差异无统计学意义(P>0.05)。结论:在针对耐多药肺结核患者治疗过程当中,纤维支气管镜药物灌注联合莫西沙星可有效提高痰菌转阴率,改善患者免疫状态,促进患者恢复,临床上应当进一步推广应用。

Objective:To investigate the effect of drug perfusion through fiberoptic bronchoscope combined with Moxifloxacin on sputum negative rate,serum T cell subsets and PCT Level in patients with multidrugresistant tuberculosis.Method:A total of 98 patients with multidrug-resistant tuberculosis admitted to our hospital from May 2016 to May 2018 were selected.According to the random number table method,they were divided into study group and control group,49 cases in each group.Both groups received routine treatment,on this basis,the control group was treated with Molevofloxacin,while study group was treated with drug perfusion through fiberoptic bronchoscope combined with Moxifloxacinon the basis of control group.The sputum negative conversion rate,focus absorption rate,T cell subsets(CD3^+,CD4^+,CD8^+),serum procalcitonin(PCT)and adverse reactions between two groups were compared.Result:After 6 and 9 months of treatment,the sputum negative conversion rate in study group were higher than those of control group(P<0.05).The total absorption rate of lesions in study group was 89.8%,which was higher than 65.3%of control group(P<0.05).After treatment,the levels of CD4^+and CD3^+of T lymphocyte subsets in study group were higher than those of control group,and the levels of PCT instudy group was lower than that of control group,the differences were statistically significant(P<0.05).But the levels of CD8^+of two groups was compared,the difference was not statistically significant(P>0.05).The adverse reactions oftwo groups was compared,the difference was not statistically significant(P>0.05).Conclusion:In treatment of mltidrug-resistant tuberculosis patients,drug perfusion through fiberoptic bronchoscope combined with Moxifloxacin can effectively improve sputum negative conversion rate,improve the immune status of patients,and promote the recovery of patients,which should be further promoted in clinical application.