纤维支气管镜药物灌注联合含环丝氨酸抗结核方案治疗耐多药肺结核患者的临床效果

Effects of Fiberoptic Bronchoscopy Drug Perfusion Combined with Cycloserine Anti-tuberculosis Regimen in the Treatment of Patients with Multi-drug Resistant Pulmonary Tuberculosis

目的探讨纤维支气管镜药物灌注联合含环丝氨酸抗结核方案治疗耐多药肺结核患者的临床效果。方法选取2017年1月至2019年12月锦州市传染病医院收治的60例耐多药肺结核患者作为研究对象,按随机数字表法分为对照组与观察组,各30例。对照组采用含环丝氨酸抗结核方案治疗,观察组在对照组治疗基础上加纤维支气管镜药物灌注,比较两组治疗结果。结果观察组治疗后病灶吸收率、痰菌转阴率、空洞缩小率高于对照组,差异有统计学意义(P<0.05);两组治疗前白细胞介素-4(IL-4)、C反应蛋白(CRP)、降钙素原(PCT)水平比较差异无统计学意义(P>0.05);观察组治疗后IL-4、CRP、PCT水平低于对照组,差异有统计学意义(P<0.05);两组治疗前CD8^(+)、CD4^(+)、CD4^(+)/CD8^(+)比较差异无统计学意义(P>0.05);观察组治疗后CD8^(+)低于对照组,CD4^(+)、CD4^(+)/CD8^(+)高于对照组,差异有统计学意义(P<0.05)。结论纤维支气管镜药物灌注联合含环丝氨酸抗结核方案治疗耐多药肺结核效果显著,可有效控制炎症介质水平,提高患者免疫细胞功能。

Objective To explore the effects of fiberoptic bronchoscopy drug perfusion combined with cycloserine anti-tuberculosis regimen in the treatment of patitients with multi-drug resistant pulmonary tuberculosis.Methods A total of 60 patients with multidrug-resistant tuberculosis admitted in Jinzhou Infectious Disease Hospital from January 2017 to December 2019 were selected as the research objects,and were assigned into a control group and an observation group by random number table,with 30 cases in each group.The control group were treated with anti-tuberculosis regimen containing cycloserine,and the observation group were perfused with fiberoptic bronchoscopy plus anti-tuberculosis regimen containing cycloserine.The treatment results of the 2 groups were compared.Results After treatment,the observation group's lesion absorption rate,sputum conversion rate and cavity reduction rate were higher than those of the control group,and the difference was statistically significant(P<0.05);there were no significant difference in the levels of interleukin-4(IL-4),C-reactive protein(CRP)and procalcitonin(PCT)between the 2 groups before treatment(P>0.05);the levels of IL-4,CRP and PCT in the observation group were lower than those in the control group after treatment,the difference was statistically significant(P<0.05);there were no significant difference in CD8^(+),CD4^(+),CD4^(+)/CD8^(+)between the 2 groups before treatment(P>0.05);after treatment,CD8^(+)in the observation group was lower than that in the control group,CD4^(+),CD4^(+)/CD8^(+)were higher than the control group,the difference is statistically significant(P<0.05).Conclusion Fibrobronchoscope drug perfusion combined with cycloserine-containing anti-tuberculosis regimen has significant effects on the treatment of multi-drug resistant pulmonary tuberculosis.It can effectively control the level of inflammatory factors and improve the immune cell function of patients.