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Received:August 18, 2019 Published Online:April 20, 2020
Received:August 18, 2019 Published Online:April 20, 2020
中文摘要: 目的 探讨母牛分枝杆菌菌苗辅助抗结核方案在肺结核治疗中的应用价值。
方法 选取2016年12月至2018年8月收治的82例肺结核患者,根据随机数字表法分为对照组与观察组,每组41例;另选80例同期健康体检者(健康组),均于入院后检测外周血T淋巴细胞亚群(CD3+、CD4+、CD4+/CD8+)水平。对照组给予2HRZE/4HR(异烟肼+利福平+吡嗪酰胺+乙胺丁醇) 抗结核方案;观察组在与对照组同样抗结核基础上,给予母牛分枝杆菌菌苗。对比两组入院时一般资料及治疗4周后病灶吸收率、外周血CD3+、CD4+、CD4+/CD8+水平、相关细胞因子[肿瘤坏死因子(TNF)-α、干扰素(IFN)-γ、白细胞介素(IL)-10],并与健康组进行淋巴细胞亚群对比。
结果 (1)入院时肺结核患者CD3+、CD4+、CD4+/CD8+水平低于健康组(P均<0.01);(2)观察组与对照组性别构成、年龄、病程均衡(P均>0.05);(3)治疗4周后观察组病灶吸收率为95.12%,高于对照组的80.49%(P<0.05);(4)治疗4周后观察组外周血CD3+、CD4+、CD4+/CD8+水平高于对照组(P<0.05,P<0.01);(5)治疗4周后观察组血清IFN-γ水平高于对照组,TNF-α、IL-10水平低于对照组(P<0.05,P<0.01)。
结论 母牛分枝杆菌菌苗辅助抗结核方案应用于肺结核患者,可调节外周血T淋巴细胞及细胞因子水平,增强机体免疫功能,促进病灶吸收。
Abstract:Objective To explore the application value of mycobacterium vaccae vaccine assisted antituberculosis regimen in the treatment of pulmonary tuberculosis.
Methods Eighty-two patients with pulmonary tuberculosis treated from December 2016 to August 2018 were selected and were randomly divided into control group and observation group(n=41,each ).In the same period,80 healthy individuals were served as healthy group.The levels of T lymphocyte subsets (CD3+,CD4+,CD4+/CD8+) in peripheral blood were detected after admission.Anti-tuberculosis therapy with isoniazide,rifampicine,pyrazinamide and ethambutol (2HRZE/4HR) was given in control group,and mycobacterium vaccae vaccine was added in observation group on the basis of the same anti-TB regimen as control group.The general data,the lesions absorption rate,the levels of CD3+,CD4+,CD4+/CD8+ before and after 4 weeks of treatment and the related cytokines (TNF-α,IFN-γ,IL-10) were compared between two groups,and the lymphocyte subsets were compared with those in healthy group.
Results The levels of CD3+,CD4+,CD4+/CD8+ in pulmonary tuberculosis patients were significantly lower than those in healthy group (all P<0.01).There were no significant differences in gender composition,age and course of disease between control group and observation group (all P>0.05).The lesions absorption rate in observation group was statistically higher than that in control group (95.12% vs 80.49%,P<0.05).After 4 weeks of treatment,the levels of CD3+,CD4+,CD4+/CD8+ and IFN-γ in observation group were higher than those in control group (P<0.05,P<0.01),while the levels of TNF-α and IL-10 were lower than those in control group (P<0.01).
ConclusionMycobacterium vaccae vaccine assisted anti-tuberculosis regimen can regulate the levels of T lymphocyte and cytokines in peripheral blood,enhance the immune function and promote focus absorption in the treatment for patients with pulmonary tuberculosis.
keywords: Pulmonary tuberculosis Mycobacterium vaccae vaccine Isoniazid Rifampicin Ethambutol Pyrazinamide [JP]T lymphocyte subsets Cytokines
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