利奈唑胺联合左氧氟沙星对耐多药肺结核患者免疫功能和炎症反应的影响

Effect of linezolid combined with levofloxacin on immune function and inflammatory reaction in patients with multidrug-resistant tuberculosis

目的分析利奈唑胺联合左氧氟沙星对耐多药肺结核(MDR-TB)患者免疫功能和炎症反应的影响。方法80例耐多药肺结核患者作为研究对象,随机分为对照组和观察组,每组40例。对照组采用经典耐药方案强化期治疗,观察组则采用以核心药物利奈唑胺联合左氧氟沙星的强化治疗方案。比较两组治疗前后免疫功能指标(CD3^(+)、CD4^(+)和CD4^(+)/CD8^(+))水平,治疗前后炎症指标[C反应蛋白(CRP)、白细胞介素-6(IL-6)和白细胞介素-8(IL-8)]水平,临床疗效。结果治疗前,两组患者CD3^(+)、CD4^(+)和CD4^(+)/CD8^(+)水平对比差异无统计学意义(P>0.05);治疗后,两组患者CD3^(+)、CD4^(+)和CD4^(+)/CD8^(+)水平均较治疗前明显提高,且观察组患者CD3^(+)、CD4^(+)和CD4^(+)/CD8^(+)水平均高于对照组,差异有统计学意义(P<0.05)。治疗前,两组CRP、IL-6和IL-8水平比较差异无统计学意义(P>0.05);治疗后,两组CRP、IL-6和IL-8水平均较治疗前明显降低,且观察组CRP、IL-6和IL-8水平均低于对照组,差异有统计学意义(P<0.05)。观察组治疗总有效率82.50%高于对照组的62.50%,差异有统计学意义(P<0.05)。结论在耐多药肺结核治疗中以利奈唑胺联合左氧氟沙星治疗可以减轻炎症反应,提高免疫功能和疗效,值得应用。

Objective To analyze the effect of linezolid combined with levofloxacin on immune function and inflammatory reaction in patients with multidrug-resistant tuberculosis.Methods A total of 80 patients with multidrug-resistant tuberculosis as study subjects were randomly divided into control group and observation group,with 40 cases in each group.The control group was treated with intensive treatment of the classic drug resistance regimen,and the observation group was treated with intensive treatment of linezolid and levofloxacin.The immune function indicators(CD3^(+),CD4^(+),CD4^(+)/CD8^(+))and inflammatory indicators[C-reactive protein(CRP),interleukin-6(IL-6),interleukin-8(IL-8)]before and after treatment,and clinical efficacy were compared between the two groups.Results Before treatment,there was no statistically significant difference in levels of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)between the two groups(P>0.05).After treatment,the levels of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)of the two groups were obviously higher than those before treatment,and the observation group was higher than the control group.All the difference was statistically significant(P<0.05).Before treatment,there was no statistically significant difference in levels of CRP,IL-6 and IL-8 between the two groups(P>0.05).After treatment,the levels of CRP,IL-6 and IL-8 of the two groups were obviously lower than those before treatment,and the observation group was lower than the control group.All the difference was statistically significant(P<0.05).The total effective rate 82.50%of the observation group was higher than 62.50%of the control group,and the difference was statistically significant(P<0.05).Conclusion Combination of linezolid and levofloxacin can relieve inflammatory reaction of patients with multidrug-resistant tuberculosis,and improve their immune function and efficacy,which is worthy of application.