莫西沙星联合卷曲霉素对耐多药肺结核患者炎性因子及免疫功能的影响

摘要

目的 探讨莫西沙星联合卷曲霉素治疗耐多药肺结核的临床疗效,并研究其对患者炎性因子及免疫功能的影响.方法 将本院2014年3月至2015年3月收治的86例耐多药肺结核患者随机分为两组,其中对照组43例采用左氧氟沙星联合卷曲霉素进行治疗,观察组43例采用莫西沙星联合卷曲霉素进行治疗.比较两组患者临床疗效、不良反应发生情况、治疗前后炎性因子及免疫功能的变化情况.结果 治疗后,观察组患者CD4+CD25+、CD4+CD25+CD127lowT细胞表达水平分别为(17.66±3.38)％、(5.33±1.10)％,明显低于对照组的(23.04±4.22)％、(6.23±1.82)％,差异有统计学意义(P＜0.05);治疗后,观察组患者血清IL-1、IL-6及TNF-α水平分别为(19.22±3.56) ng/ml、(150.76±13.25) ng/ml、(86.39±9.77)ng/ml,明显低于对照组的(25.37±4.56) ng/ml、(190.88±19.52)ng/ml、(114.28±11.42) ng/ml,差异有统计学意义(P＜0.05);观察组患者痰菌转阴率、病灶吸收好转率及空洞缩小率分别为93.02％、88.37％及83.72％,明显高于对照组的81.40％、76.74％及74.42％,差异有统计学意义(P＜0.05);两组患者临床不良反应发生率差异无统计学意义(P＞0.05).结论 莫西沙星联合卷曲霉素治疗耐多药肺结核效果显著,能够有效改善炎症反应和提高免疫功能,值得临床推广.%Objective To investigate the curative effect of moxifloxacin combined with capreomycin on patients with multi-drug resistant tuberculosis,and the changes of inflammatory factors and immune function.Methods 86 patients with multi-drug resistant tuberculosis in our hospital from March 2014 to March 2015 were randomly divided into two groups,43 cases in each group.The control group was treated with levofloxacin combined with capreomycin,while the observation group was treated with moxifloxacin combined with capreomycin.Compared the differences of the clinical effect,adverse reactions,and the changes of inflammatory factors and immune function before and after treatment between the two groups.Results After treatment,the levels of CD4+CD25+ and CD4+CD25+CD127low T cells of the observation group were (17.66±3.38)％ and (5.33±1.10)％,significantly lower than (23.04±4.22)％ and (6.23±1.82)％ of the control group (P＜0.05);the levels of serum IL-1,IL-6,and TNF-α of the observation group were (19.22±3.56) ng/ml,(150.76±13.25) ng/ml,(86.39±9.77) ng/ml,significantly lower than (25.37±4.56) ng/ml,(190.88±19.52) ng/ml,(114.28±11.42) ng/ml of the control group (P＜0.05).The sputum negative conversion rate,focus absorption and improvement rate,and cavity shrinkage rate of the observation group were 93.02％,88.37％,83.72％,significantly higher than 81.40％,76.74％,74.42％ of the control group (P＜0.05).There was no statistically significant difference in the rate of adverse effects between the two groups (P＞0.05).Conclusion Moxifloxacin combined with capreomycin has significant effect in the treatment of multi-drug resistant tuberculosis,which can effectively improve the inflammatory reaction and immune function,worthy of clinical promotion.