支气管动脉栓塞术治疗肺结核患者咯血的疗效

Effect of bronchoarterial embolization on hemoptysis of tuberculosis

目的:探究支气管动脉栓塞术(BAE)治疗肺结核患者咯血的疗效及其对预后的影响。方法:回顾性分析124例肺结核咯血患者的临床资料,根据治疗方式的不同将其分为观察组和对照组,每组62例。2组患者均接受抗感染、抗结核、营养支持等基础治疗。对照组加用垂体后叶注射液进行止血治疗,观察组加以BAE治疗。比较2组患者治疗前、后血清碱性成纤维细胞生长因子(bFGF)、血管内皮生长因子-A(VEGF-A)、白细胞介素(IL)-1、IL-6、IL-10及免疫球蛋白IgG、IgA、IgM水平,观察临床疗效、不良反应及其预后。结果:观察组总有效率显著高于对照组(95.16%vs. 82.26%,P<0.05);治疗后2组患者血清bFGF、VEGF-A、IL-1、IL-6水平降低,且观察组低于对照组;IL-10、IgG、IgA、IgM水平升高,且观察组高于对照组(P均<0.05)。2组患者的不良反应发生率比较,差异无统计学意义(P>0.05),治疗后1年内观察组咯血总死亡率显著低于对照组(P<0.05)。结论:BAE治疗肺结核咯血患者疗效确切,可降低炎症因子水平,并改善患者免疫功能及其预后。

Objective:To explore the effect of bronchial artery embolization(BAE)in the treatment of pulmonary tuberculosis hemoptysis and its impact on prognosis.Methods:A retrospective study was conducted on the clinical data of 124 patients with pulmonary tuberculosis hemoptysis.According to different treatment methods,the patients were divided into an observation group(62 cases)and a control group(62 cases).The control group was treated with pituitary posterior lobe injection for hemostasis,and the observation group was treated with BAE in addition to basic treatment.The changes of levels of serum basic fibroblast growth factor(bFGF)and vascular endothelial growth factor-A(VEGF-A),interleukin-1(IL-1),IL-6,IL-10 and immunoglobulin IgG,IgA,IgM were compared between the two groups before and after treatment.The adverse reactions were observed,and the clinical efficacy and prognosis were compared.Results:The total effective rate in the observation group was 95.16%,which was significantly higher than 82.26%of the control group(P<0.05).Compared with before treatment,the levels of serum bFGF,VEGF-A,IL-1 and IL-6 decreased,IL-10,IgG,IgA and IgM increased in the two groups after treatment(all P<0.05).Compared with the control group,the levels of serum bFGF,VEGF-A,IL-1 and IL-6 decreased,IL-10,IgG,IgA and IgM increased in the observation group after treatment(all P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).The total mortality of hemoptysis in the observation group was significantly lower than that in the control group(P<0.05).Conclusions:BAE is effective in the treatment of pulmonary tuberculosis hemoptysis,and can reduce the level of inflammatory factors,and improve the immune function and prognosis.