胸腺五肽联合左氧氟沙星治疗对复治菌阳性肺结核实验室指标及临床疗效的影响

摘要

目的 探讨胸肽五肽联合左氧氟沙星对复治菌阳性肺结核患者炎性因子、细胞免疫的影响,分析其可能作用机制.方法 我院收治的复治菌阳性肺结核患者60例,采用随机数字表法分为观察组和对照组各30例,均给予3 hRZE/6 hRE常规抗结核治疗方案,对照组加用盐酸左氧氟沙星胶囊,观察组在对照组基础上联合应用胸腺五肽,治疗8周后,比较血清炎性因子、细胞免疫功能、不良反应、临床疗效等指标.结果 观察组痰菌转阴率、病灶吸收率、空洞闭合缩小率、临床症状改善率均高于对照组;血清白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)等含量低于对照组;CD3+、CD4+、CD4+/CD8+高于对照组(P<0.05);两组不良反应比较差异无统计学意义(P>0.05).结论 胸腺五肽联合左氧氟沙星有助于提高复治菌阳性肺结核患者临床疗效,可能与缓解患者炎症状态、改善免疫等因素有关.%Objective To investigate the effect of thymopentin combined with levofloxacin therapy on inflammatory cytokines and immune function in relapsing pulmonary tuberculosis,and analyzed the possible mechanisms.Methods Sixty patients with relap-sing pulmonary tuberculosis were divided into observation or control group,30 in each group.The all patients were given 3 hRZE/6 hRE routine anti-tuberculosis therapy.The control group was added levofloxacin while the observation group was further given thymopentin and levofloxacin in the base of the control group.After 8 weeks of treatment,serum inflammatory cytokines,cellular immune function, adverse reactions,and clinical curative effect were compared between the two groups.Results Sputum bacteria turn rate,lesions ab-sorption rate,rate of empty closed or reduced and clinical symptoms improvement rate in the observation group were significant higher than those in the control group (P < 0.05).Serum levels of IL-6,IL-10 and TNF-α in the observation group were significantly lower than control group while CD3+,CD4+,CD4+/CD8+were significantly higher than control group (P<0.05).There were no significant difference in adverse reactions between the two groups(P>0.05).Conclusion Thymopentin combined with levofloxacin therapy help to improve clinical curative effect of relapsing pulmonary tuberculosis.It may be related to relieve the inflammation status and improve the immune function.