利奈唑胺联合环丝氨酸胶囊治疗肺结核对患者免疫细胞以及X-pert MTB/RIF以及肺CT的影响研究

Effect of Linezolid Combined with Cycloserine Capsules on Immune Cells,X-pert MTB/RIF,and Lung CT in Patients with Pulmonary Tuberculosis

目的探讨利奈唑胺联合环丝氨酸胶囊治疗肺结核对患者免疫细胞以及Xpert MTB/RIF的影响,评价临床效果及安全性。方法回顾性分析我院2017年9月至2019年7月收治的185例肺结核患者的临床资料,按照入院治疗方案不同分为观察组与对照组。对照组(n=90):给予单纯利奈唑胺治疗;观察组(n=95):在对照组基础上联合环丝氧酸胶囊治疗,采集患者治疗前及治疗2个月后全血,应用流式细胞仪检测CD^(4+)、CD^(8+)T细胞水平,并依据患者治疗前后肺功能改变及X-pert MTB/RIF检测结果评价治疗效果。结果两组患者治疗前呼吸功能指标FVC、FEV_(1)%、FEV_(1)/FVC差异无统计学意义(P>0.05)。治疗后两组患者FVC均升高,呼吸功能均有改善,且观察组患者治疗后各呼吸功能升高显著(P<0.05);观察组患者治疗两个月后抗酸染色及Gene Xpert Mtb/RIF检测结果痰结核杆菌数目低于对照级;GeneXpert Mtb/RIF检测阳性率高于抗酸染色结果(P<0.05);两组患者治疗前CD^(4+)、CD^(8+)T细胞等免疫细胞水平差异无统计学意义(P>0.05);治疗后两组患者CD^(4+)T细胞、CD^(4+)/CD^(8+)升高,CD^(8+)T细胞降低,且观察组各指标改善显著,P<0.05;观察组患者治疗后有效率为89.5%(85/95),显著高于对照组[64.4%(56/90),(P<0.05)]。观察组患者治疗后胸部CT效果明显优于对照组。结论利奈唑胺联合环丝氨酸胶囊治疗肺结核疗效显著,可提高患者机体免疫细胞含量,改善患者肺功能状态,降低患者痰液中结核杆菌含量,对比单纯利奈唑胺治疗效果显著提升,更适用于临床结核病治疗。

Objective To investigate the effect of linezolid combined with cycloserine Capsule on immune cells and X-pert MTB/RIF in patients with pulmonary tuberculosis and evaluate the clinical effect and safety.Methods The clinical data of 185 patients with pulmonary tuberculosis treated in our hospital from September 2017 to July 2019 were retrospectively analyzed and divided into observation and control groups according to the different treatment schemes.The control group(n=90):treated with linezolid alone;the observation group(n=95):treated with cycloserine capsules based on the control group.Blood samples were collected from patients before and after two months of treatment,and the levels of CD^(4+) and CD^(8+) T cells were detected by flow cytometry.The therapeutic effect was evaluated according to the lung function changes and X-pert MTB/RIF test results before and after treatment.Results There was no significant difference in FVC,FEV_(1)%,FEV_(1)/FVC between the two groups before treatment(P>0.05).After treatment,FVC increased,and respiratory function improved in both groups,and respiratory function increased significantly in the observation group(P<0.05).After two months of treatment,the number of sputum tuberculosis bacilli detected by acid-fast staining and Gene Xpert Mtb/RIF test in the observation group was lower than that in the control group;the positive rate of Gene Xpert Mtb/RIF test was higher than that of acid-fast staining(P<0.05).There was no significant difference in the levels of CD^(4+),CD^(8+)T cells,and other immune cells between the two groups before treatment(P>0.05).After treatment,the levels of CD^(4+)T cells,CD^(4+)/CD^(8+)increased,and CD^(8+)T cells decreased in the two groups,and the indexes in the observation group improved significantly(P<0.05).The effective rate was 89.5%(85/95)in the observation group after treatment,which was significantly higher than 64.4%(58/90)in the control group(P<0.05).After treatment,the chest CT effect of the observation group was significantly better than that of the control group.Conclusion Linazolamide combined with cycloserine capsule has a remarkable curative effect in the treatment of tuberculosis,which can improve the immune cell content of patients,improve the pulmonary function status of patients,reduce the content of tuberculosis bacilli in patients sputum,significantly improve the therapeutic effect compared with linezolid alone,and is more suitable for clinical tuberculosis treatment.