左氧氟沙星辅助四联抗结核方案治疗结核性胸膜炎的疗效及对细胞因子水平的影响

Effect of Levofloxacin Assisted Quadruple Anti-tuberculous Regimen on Tuberculous Pleurisy and Its Effect on Cytokine Levels

目的探讨左氧氟沙星辅助四联抗结核方案治疗结核性胸膜炎的疗效及对细胞因子水平的影响。方法选择2021年1—12月扬州市第三人民医院收治的结核性胸膜炎患者160例为研究对象,按数表随机法分为对照组(80例,四联抗结核方案治疗)与观察组(80例,左氧氟沙星辅助四联抗结核方案治疗)。观察患者疗效、胸膜厚度及胸腔积液消失时间,并测定其细胞因子与免疫指标评估炎症反应、免疫功能。结果观察组总有效率(93.75%)高于对照组(80.00%),差异有统计学意义(χ^(2)=6.632,P<0.05)。治疗前,两组胸膜厚度对比,差异无统计学意义(P>0.05);治疗后,观察组胸膜厚度小于对照组,且胸腔积液消失时间短于对照组,差异有统计学意义(P<0.05)。两组治疗前IFN-γ、IL-2、IL-4、IL-10水平对比,差异无统计学意义(P>0.05);治疗后,观察组IFN-γ、IL-2水平低于对照组,而IL-4、IL-10水平则高于对照组,差异有统计学意义(P<0.05)。治疗前,两组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平对比,差异无统计学意义(P>0.05);治疗后,观察组各免疫指标水平高于对照组,差异有统计学意义(P<0.05)。结论结核性胸膜炎患者四联抗结核方案治疗中辅以左氧氟沙星,可提高疗效,利于患者症状的改善,且对细胞因子水平与免疫功能有较好的调节作用。

Objective To investigate the effect of levofloxacin assisted quadruple anti-tuberculous regimen in the treatment of tuberculous pleurisy and its influence on cytokine levels.Methods 160 patients with tuberculous pleurisy admitted to the Third People's Hospital of Yangzhou from January to December 2021 were selected as the research subjects.They were randomly divided into a control group(80 cases,treated with a quadruple anti tuberculosis regimen)and an observation group(80 cases,treated with levofloxacin as an adjuvant quadruple anti tuberculosis regimen)using a number table method.Observed the patient's efficacy,pleural thickness,and the disappearance time of pleural effusion,and measured their cytokines and immune indicators to evaluate inflammatory response and immune function.Results The total treatment efficiency of the observation group(93.75%)was higher than that of the control group(80.00%),and the difference was statistically significant(χ^(2)=6.632,P<0.05).Before treatment,there was no statistically significant difference in pleural thickness between the two groups(P>0.05);after treatment,the pleural thickness of the observation group was smaller than that of the control group,and the disappearance time of pleural effusion was shorter than that of the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the levels of IFN-γ,IL-2,IL-4,and IL-10 between the two groups before treatment(P>0.05);after treatment,the levels of IFN-γand IL-2 in the observation group were lower than those in the control group,while the levels of IL-4 and IL-10 were higher than those in the control group,and the difference was statistically significant(P<0.05).Before treatment,there was no statistically significant difference in the levels of CD3^(+),CD4^(+),CD4^(+)/CD8^(+)between the two groups(P>0.05);after treatment,the levels of various immune indicators in the observation group were higher than those in the control group,and the difference was statistically significant(P<0.05).Conclusion Levofloxacin as an adjuvant in the quadruple anti-tuberculosis regimen for patients with tuberculous pleuritis can improve the curative effect,which is conducive to the improvement of patients'symptoms,and has a good regulatory effect on cytokine levels and immune function,which is worthy of promotion.