乙酰半胱氨酸雾化吸入联合常规抗结核方案治疗重症肺结核的效果及对炎性因子、MALAT1、IP-10、MMP-9水平的影响

Effect of acetylcysteine atomization inhalation combined with conventional anti-tuberculosis regimen in the treatment of severe pulmonary tuberculosis and its influence on the inflammatory factors,MALAT1,IP-10 and MMP-9 levels

目的探讨乙酰半胱氨酸雾化吸入联合常规抗结核方案治疗重症肺结核的效果及对炎性因子、MALAT1、IP-10、MMP-9水平的影响。方法选取2018年2月至2020年10月收治的306例重症肺结核患者为研究对象,按治疗方案将其分为对照组和观察组,每组153例。对照组接受常规抗结核方案治疗,观察组在对照组基础上联合乙酰半胱氨酸雾化吸入。比较两组的临床疗效、炎性因子、MALAT1、IP-10、MMP-9水平和免疫功能指标。结果观察组的治疗总有效率为97.39%,显著高于对照组的89.54%,差异具有统计学意义(P<0.05)。治疗后,两组的IFN-γ、PCT、IL-4水平均显著降低,且观察组低于对照组,差异具有统计学意义(P<0.05)。治疗后,两组的MALAT1、IP-10及MMP-9水平均显著降低,且观察组低于对照组,差异具有统计学意义(P<0.05)。治疗后,两组的Treg均降低,Th17及Th17/Treg均升高,且观察组的Treg低于对照组,Th17、Th17/Treg高于对照组,差异具有统计学意义(P<0.05)。结论乙酰半胱氨酸雾化吸入与常规抗结核方案联合应用于重症肺结核治疗中效果满意,可减轻机体炎症反应,调节MALAT1、IP-10与MMP-9水平,还能改善免疫功能指标,值得推广。

Objective To investigate the effect of acetylcysteine atomization inhalation combined with conventional anti-tuberculosis regimen in the treatment of severe pulmonary tuberculosis and its influence on the inflammatory factors,MALAT1,IP-10 and MMP-9 levels.Methods A total of 306 patients with severe pulmonary tuberculosis treated from February 2018 to October 2020 were selected as the research objects.The patients were divided into control group and observation group according to the treatment scheme,with 153 cases in each group.The control group was treated with conventional anti-tuberculosis regimen,and the observation group was combined with acetylcysteine atomization inhalation on the basis of the control group.The clinical efficacy,inflammatory factors,MALAT1,IP-10,MMP-9 levels and immune function indexes were compared between the two groups.Results The total effective rate of treatment in the observation group was 97.39%,which was significantly higher than 89.54%in the control group,and the difference was statistically significant(P<0.05).After treatment,the levels of IFN-γ,PCT and IL-4 decreased significantly in both groups,and those in the observation group were lower than the control group,the differences were statistically significant(P<0.05).After treatment,the levels of MALAT1,IP-10 and MMP-9 decreased significantly in both groups,and those in the observation group were lower than the control group,the differences were statistically significant(P<0.05).After treatment,the Treg of the two groups decreased,while Th17 and Th17/Treg increased,and the Treg of the observation group was lower than that of the control group,Th17 and Th17/Treg were higher than those of the control group,the differences were statistically significant(P<0.05).Conclusion Acetylcysteine atomization inhalation combined with conventional anti-tuberculosis regimen applied in the treatment of severe pulmonary tuberculosis has a satisfactory effect.It can redice the inflammatory response of body,regulate the levels of MALAT1,IP-10 and MMP-9,and improve immune function indexes,which is worth popularizing.