结核丸联合含环丝氨酸化疗方案对耐多药肺结核患者肺功能和外周血Th1/Th17细胞免疫反应的影响

Effects of Tuberculosis Pills Combined with Cycloserine Containing Chemotherapy on Lung Function and Th1/Th17 Cells Immune Responses of Peripheral Blood in Patients with Multidrug-Resistant Tuberculosis

目的:探讨结核丸联合含环丝氨酸化疗方案对耐多药肺结核(MDR-TB)患者肺功能和外周血辅助性T细胞(Th)1/Th17细胞免疫反应的影响。方法:将我院于2018年5月~2020年3月期间收治的98例MDR-TB患者根据信封抽签法分为对照组(49例,含环丝氨酸化疗方案治疗)和观察组(49例,结核丸联合含环丝氨酸化疗方案治疗)。对比两组痰菌阴转率、病灶吸收率、空洞闭合率、肺功能指标、外周血Th1/Th17细胞免疫反应相关指标和不良反应发生率。结果:观察组的病灶吸收率、痰菌阴转率、空洞闭合率均高于对照组,不良反应总发生率显著低于对照组(P<0.05)。观察组治疗后最大呼气流量(PEF)、第1秒用力呼气容积(FEV1)、用力肺活量(FVC)高于对照组同期(P<0.05)。观察组治疗后Th1、γ-干扰素(IFN-γ)高于对照组同期,Th17、白细胞介素(IL)-17低于对照组同期(P<0.05)。结论:含环丝氨酸化疗方案联合结核丸治疗MDR-TB,可有效改善患者的肺功能,调节外周血Th1/Th17细胞免疫反应。

Objective:To investigate the effects of tuberculosis pills combined with cycloserine containing chemotherapy on lung function and peripheral blood T helper cells(Th)1/Th17 cells immune responses of peripheral blood in patients with multidrug-resistant tuberculosis(MDR-TB).Methods:98 MDR-TB patients who were admitted to our hospital from May 2018 to March 2020 were divided into control group(49 cases,cycloserine-containing chemotherapy regimen)and observation group(49 cases,tuberculosis pill combined with cycloserine-containing chemotherapy regimen)according to envelope lottery method.Sputum negative conversion rate,lesion absorption rate,cavity closure rate,lung function index,peripheral blood Th1/Th17 cell immune response related index and incidence of adverse reactions were compared in the two groups.Results:The lesion absorption rate,sputum negative conversion rate and cavity closure rate in the observation group were higher than those in the control group,and the total incidence of adverse reactions was significantly lower than that in the control group(P<0.05).After treatment,the maximum expiratory flow(PEF),forced expiratory volume in the first second(FEV1)and forced vital capacity(FVC)in the observation group were higher than those in the control group at the same period(P<0.05).After treatment,Th1 andγ-interferon(IFN-γ)in the observation group were higher than those in the control group at the same period,and Th17 and interleukin(IL)-17 were lower than those in the control group at the same period(P<0.05).Conclusion:Cycloserine-containing chemotherapy combined with tuberculosis pill in the treatment of MDR-TB,which can effectively improve the lung function of patients,and regulate the immune response of peripheral blood Th1/Th17 cells.