环丝氨酸联合胸腺肽肠溶片治疗耐多药肺结核的效果及对患者细胞免疫功能的影响

Effect of cycloserine combined with thymosin enteric-coated tablet in treatment of multidrug resistant tuberculosis and its effect on patients′cellular immune function

目的观察环丝氨酸联合胸腺肽肠溶片治疗耐多药肺结核的效果,分析其对患者细胞免疫功能的影响。方法选取2016年5月至2017年8月我院收治的耐多药肺结核患者69例为研究对象。采用随机数字表法将其分为环丝组(n=34)及对照组(n=35)。对照组采用耐多药肺结核标准治疗方案进行治疗,环丝组在对照组的基础上采用环丝氨酸联合胸腺肽溶片治疗,治疗周期为24个月,评估两组治疗前后的临床效果及治疗前后的免疫指标变化情况。结果治疗24个月后,环丝组痰结核菌转阴、胸部X线病灶吸收及空洞缩小较治疗3个月后显著升高,较对照组显著升高,差异有统计学意义(P<0.05);环丝组患者的CD4^(+)、CD4^(+)/CD8^(+)显著高于对照组,CD8^(+)显著低于对照组,差异有统计学意义(P<0.05)。结论环丝氨酸联合胸腺肽肠溶片治疗耐多药肺结核具有良好的临床转归效果,可进一步提高肺结核诊治疗效。

Objective To observe the effect of cycloserine combined with thymosin enteric coated tablets in the treatment of multidrug resistant tuberculosis(MDR-TB),and to analyze the effect on the cellular immune function of patients.Methods A total of 69 patients with MDR-TB admitted to our hospital from May 2016 to August 2017 were selected as the research objects.By random number table method,the patients were divided into the cycloserine group(n=34)and the control group(n=35).The control group was treated with the standard treatment plan of MDR-TB,and the cycloserine group was treated with cycloserine combined with thymosin tablets on the basis of the control group.The treatment period was 24 months.The clinical effect and the changes of immune indexes before and after treatment were evaluated in the two groups.Results In the cycloserine group,the cavity reduction,chest X-ray lesion absorption and turning negative sputum tuberculosis bacterium after 24 months of treatment were significantly higher than those after 3 months of treatment,and which was higher than those in the control group,with significant difference(P<0.05).The CD4^(+),CD4^(+)/CD8^(+) in the cycloserine group were significantly higher than those in the control group,and the CD8^(+) in the cycloserine group was significantly lower than that in the control group,with significant difference(P<0.05).Conclusion Cycloserine combined with thymosin enteric-coated tablet in the treatment of multidrug resistant tuberculosis has a good clinical outcome and can further improve the curative effect of tuberculosis diagnosis and treatment.