莫西沙星联合母牛分枝杆菌治疗耐多药肺结核患者的临床效果及对免疫功能的影响

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摘要目的探讨莫西沙星联合母牛分枝杆菌治疗耐多药肺结核患者的临床效果及对免疫功能的影响。方法选取2017年3月22日～2018年3月22日我院收治的100 例耐多药肺结核患者为研究对象，采用数据库随机分组法将其分为观察组与对照组，每组各50 例。观察组实施莫西沙星联合母牛分枝杆菌治疗，对照组实施常规化疗干预。比较两组的T 淋巴细胞8（CD8+）、T 淋巴细胞4（CD4+）、CD4+/CD8+、T 淋巴细胞3（CD3+）、血清白细胞介素-1（IL-1）、血清白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、治疗总有效率、治疗后6、12 个月的痰菌阴转率。结果观察组的CD4+/CD8+为（1.98±0.24），CD8+水平为（28.75±2.41）%，CD4+水平为（42.57±4.31）%，CD3+水平为（69.12±4.19）%，治疗后6 个月的痰菌阴转率为64.00%，治疗后12 个月的痰菌阴转率为92.00%，治疗总有效率为96.00%；对照组的CD4+/CD8+为（1.19±0.05），CD8+水平为（26.13±1.35）%，CD4+水平为（36.28±3.66）%，CD3+水平为（62.45±3.26）%，治疗后6 个月的痰菌阴转率为40.00%，治疗后12 个月的痰菌阴转率为68.00%，治疗总有效率为68.00%。观察组的CD4+/CD8+、CD8+、CD4+、CD3+、治疗后6 个月痰菌阴转率、治疗后12 个月痰菌阴转率、治疗总有效率均高于对照组，差异有统计学意义（P＜0.05）。观察组的IL-1 为（18.53±2.39）ng/ml，IL-6 为（152.39±12.19）ng/ml，TNF-α 水平为（85.23±3.11）ng/ml；对照组的IL-1 为（26.37±3.18）ng/ml，IL-6 为（185.52±20.31）ng/ml，TNF-α 水平为（108.69±8.49）ng/ml；观察组的IL-1、IL-6、TNF-α 水平低于对照组，差异有统计学意义（P＜0.05）。结论莫西沙星联合母牛分枝杆菌治疗耐多药肺结核患者的临床效果显著，可降低炎性介质水平，提高痰菌阴转率。

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	李雪华

关键词 ：莫西沙星, 母牛分枝杆菌, 耐多药肺结核, 临床疗效, 免疫功能

Abstract：Objective To explore the clinical effect of Moxifloxacin combined with Mycobacterium vaccae in the treatment of patients with multidrug-resistant pulmonary tuberculosis and its influence on immune function.Methods One hundred patients with multidrug-resistant pulmonary tuberculosis admitted to our hospital from March 22, 2017 to March 22, 2018 were selected as subjects, they were divided into observation group and control group by database random grouping method, with 50 cases in each group.The observation group was treated with Moxifloxacin combined with Mycobacterium vaccae, and the control group was treated with conventional chemotherapy.The indicators of T lymphocyte 8 (CD8+), T lymphocyte 4 (CD4+), CD4+/CD8+, T lymphocyte 3 (CD3+), serum interleukin-1 (IL-1), serum interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), total effective rate, sputum negative conversion rate 6 months after treatment, and sputum negative conversion rate 12 months after treatment were compared between the two groups.Results In the observation group, CD4+/CD8+was (1.98±0.24), the level of CD8+was (28.75±2.41)%, the level of CD4+was(42.57±4.31)%, the level of CD3+was (69.12±4.19)%, sputum negative conversion rate of 6 months after treatment was 64.00%, sputum negative conversion rate of 12 months after treatment was 92.00% and the total effective rate was 96.00%.In the control group, CD4+/CD8+was (1.19±0.05), the level of CD8+ was (26.13±1.35)%, the level of CD4+ was(36.28±3.66)%, the level of CD3+was (62.45±3.26)%, sputum negative conversion rate of 6 months after treatment was 40.00%, sputum negative conversion rate of 12 months after treatment was 68.00%, and the total effective rate was 68.00%.The indicators of CD4+/CD8+, CD8+, CD4+, CD3+, sputum negative conversion rate of 6 months after treatment,sputum negative conversion rate of 12 months after treatment and total effective rate in the observation group were higher than those in the control group, the differences were statistically significant (P＜0.05).In the observation group,the levels of IL-1, IL-6, and TNF-α were (18.53±2.39), (152.39±12.19) and (85.23±3.11) ng/ml.In the control group,the levels of IL-1, IL-6, and TNF-α were (26.37±3.18), (185.52±20.31), and (108.69±8.49) ng/ml, respectively.The levels of IL-1, IL-6 and TNF-α in observation group were lower than those in the control group, the differences were statistically significant (P＜0.05).Conclusion The clinical effect of Moxifloxacin combined with Mycobacterium vaccae in the treatment of patients with multidrug-resistant pulmonary tuberculosis is remarkable, which can reduce the level of inflammatory mediators and increase the negative conversion rate of sputum and bacterium.

Key words： Moxifloxacin Mycobacterium vaccae Multidrug-resistant pulmonary tuberculosis Clinical efficacy Immunity

引用本文:

李雪华. 莫西沙星联合母牛分枝杆菌治疗耐多药肺结核患者的临床效果及对免疫功能的影响[J]. 中国当代医药, 2020, 27(3): 58-60.
LI Xue-hua. Clinical effect of Moxifloxacin combined with Mycobacterium vaccae in the treatment of patients with multidrug-resistant pulmonary tuberculosis and its influence on immunity. 中国当代医药, 2020, 27(3): 58-60.

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http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2020/V27/I3/58

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