注射用胸腺肽α1联合环丝氨酸治疗耐多药肺结核的临床疗效及对免疫功能的影响

The clinical effect of thymosinα1 injection combined with cycloserine in the treatment of MDR-TB and its effect on immune function

目的探究注射用胸腺肽α1联合环丝氨酸治疗耐多药肺结核的临床疗效及对免疫功能的影响。方法选取2016年7月至2018年7月收治的92例耐多药肺结核患者作为研究对象,按照随机数字表法分为对照组和观察组,每组各46例。对照组在常规治疗基础上给予环丝氨酸治疗,观察组在对照组基础上联合注射用胸腺肽α1治疗。比较2组患者的不良反应发生情况、痰菌阴转情况、病灶吸收情况、空洞闭合情况、免疫功能指标CD4^+、CD8^+T淋巴细胞数目及CD4^+/CD8^+比值水平变化情况。结果2组患者不良反应发生率比较,差异无统计学意义(P>0.05)。观察组患者1个疗程结束后的痰菌阴转率、病灶吸收情况、空洞闭合情况及治疗6、12、18个月时的痰菌阴转率均优于对照组(P<0.05)。与治疗前相比,治疗后2组患者的CD4^+T淋巴细胞数目及CD4^+/CD8^+均升高,CD8^+T淋巴细胞数目均降低(P<0.05)。治疗后,与对照组相比,观察组患者的CD4^+T淋巴细胞数目及CD4^+/CD8^+升高,CD8^+T淋巴细胞数目降低(P<0.05)。结论注射用胸腺肽α1联合环丝氨酸治疗耐多药肺结核较单独使用环丝氨酸可提高临床疗效,增强患者免疫功能。

Objective To explore the clinical efficacy of thymosinα1 injection combined with cycloserine in the treatment of multi-drug resistant tuberculosis(MDR-TB)and its influence on immune function.Methods Totally 92 patients with MDR-TB admitted from July 2016 to July 2018 were selected as the study subjects.They were divided into control group and observation group according to random number table method,with 46 cases in each group.The control group was treated with cycloserine on the basis of conventional treatment,and the observation group was treated with thymosinα1 on the basis of the control group.The incidence of adverse reactions,sputum negative transformation,focus absorption,cavity closure,immune function index CD4^+,CD8^+T lymphocyte number and CD4^+/CD8^+ratio were compared between the two groups.Results There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).After one course of treatment,The sputum negative conversion rate,focus absorption,cavity closure and sputum negative conversion rate at 6,12 and 18 months in the observation group were better than those in the control group(P<0.05).Compared with before treatment,the number of CD4^+T lymphocyte and the ratio of CD4^+/CD8^+increased in both groups after treatment,while the number of CD8^+T lymphocyte decreased in both groups(P<0.05).After treatment,compared with the control group,the number of CD4^+T lymphocyte and the ratio of CD4^+/CD8^+in the observation group increased,while the number of CD8^+T lymphocyte was decreased(P<0.05).Conclusion Compared with cycloserine alone application,thymosinα1 injection combined with cycloserine can improve the clinical efficacy and immune function of patients with MDR-TB.