本文選題：肺結(jié)核　切入點(diǎn)：肺功能　出處：《醫(yī)學(xué)綜述》2016年21期 　論文類型：期刊論文

【摘要】：目的探討抗結(jié)核感染免疫療法治療肺結(jié)核的療效及對(duì)免疫功能和生活質(zhì)量的影響。方法回顧性分析2012年5月至2014年12月在華北石油管理局總醫(yī)院治療的70例結(jié)核分枝桿菌陽性的初治肺結(jié)核患者的臨床資料,按照治療方法不同分為對(duì)照組和觀察組,各35例。對(duì)照組給予0.3 g異煙肼、1.5 g吡嗪酰胺、0.75 g乙胺丁醇口服,靜脈滴注0.6 g利福平,每日1次。觀察組在對(duì)照組基礎(chǔ)上給予靜脈滴注0.08 g胸腺五肽,每日1次。兩組患者均治療16周。觀察兩組患者的臨床療效,治療前后的肺功能、免疫功能、炎性因子和生活質(zhì)量。結(jié)果 (1)療效:觀察組陰轉(zhuǎn)率為82.9%(29/35),對(duì)照組為71.4%(25/35),組間比較差異無統(tǒng)計(jì)意義(P0.05);觀察組病灶吸收率為85.7%(30/35),對(duì)照組為82.9%(29/35),組間比較差異無統(tǒng)計(jì)意義(P0.05)。(2)肺功能:治療后,觀察組第一秒用力呼氣量、第一秒用力呼氣量占用力肺活量比值、用力呼氣25%時(shí)瞬間流速、用力呼氣50%時(shí)瞬間流速高于對(duì)照組[(1.92±0.32)L比(1.62±0.24)L,(74.31±2.13)%比(67.82±1.63)%,(73.82±11.33)L/s比(65.14±12.61)L/s,(80.21±9.73)L/s比(72.12±11.12)L/s],差異有統(tǒng)計(jì)學(xué)意義(P0.01)。(3)免疫功能:治療后,觀察組IgG高于對(duì)照組[(11.22±2.63)g/L比(9.73±2.74)g/L],IgE低于對(duì)照組[(107.92±56.24)ng/L比(223.53±34.82)ng/L],差異有統(tǒng)計(jì)學(xué)意義(P0.05)。(4)炎性因子:治療后,觀察組白細(xì)胞介素(IL)-6、IL-8、腫瘤壞死因子α低于對(duì)照組[(86.72±9.95)μg/L比(99.24±10.81)μg/L,(0.31±0.14)μg/L比(0.38±0.11)μg/L,(90.53±22.32)ng/L比(102.73±20.82)ng/L],差異有統(tǒng)計(jì)學(xué)意義(P0.05)。(5)生活質(zhì)量:治療后,觀察組生活質(zhì)量評(píng)分低于對(duì)照組[(16±6)分比(24±7)分],差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論抗結(jié)核感染免疫療法治療肺結(jié)核能明顯緩解臨床癥狀,改善患者肺功能和生活質(zhì)量,提高機(jī)體免疫功能。
[Abstract]:Objective to investigate the effect of immunotherapy against tuberculosis infection on pulmonary tuberculosis and its effect on immune function and quality of life. Methods 70 cases of tuberculosis treated in the General Hospital of North China Petroleum Administration Bureau from May 2012 to December 2014 were retrospectively analyzed. Clinical data of Mycobacterium positive patients with Primary Pulmonary Tuberculosis, The control group was given 0.3 g isoniazid and 1.5 g pyrazinamide 0.75 g ethambutanol orally, and 0.6 g rifampicin was injected intravenously. The observation group received 0.08 g thymic pentapeptide intravenously once a day once a day. The patients in both groups were treated for 16 weeks. The clinical efficacy, lung function and immune function before and after treatment were observed. Inflammatory factors and quality of life. Results 1) curative effect: the negative conversion rate of the observation group was 82.9% / 35%, the control group was 71.4% / 35%, the difference between the two groups had no statistical significance (P0.05%), the focus absorption rate of the observation group was 85.7% 30 / 35%, the control group was 82.9% / 2935%, the difference between the two groups had no statistical significance (P 0.05%.) after treatment, the lung function of the observation group was 85.7% 30% 35%, and that of the control group was 82.9% 29% 35%. There was no statistical significance between the two groups in lung function: after treatment, In the observation group, the forced expiratory volume at 1 second, the ratio of forced expiratory volume to forced vital capacity at 1 second, and the instantaneous flow rate at 25 hours after forced exhalation, The instantaneous flow rate in the forced expiratory 50 was higher than that in the control group (1.92 鹵0.32 L / L vs 1.62 鹵0.24 L / L = 74.31 鹵2.13% vs 67.82 鹵1.63 L / s = 65.14 鹵12.61 L / s vs 65.14 鹵12.61 L / s / s = 72.12 鹵11.12 L / s respectively). The IgG in the observation group was higher than that in the control group [11.22 鹵2.63 g / L vs 9.73 鹵2.74 g / L] and was lower than that in the control group [107.92 鹵56.24 ng / L vs 223.53 鹵34.82 ng / L]. IL-8, TNF- 偽 were significantly lower in the observation group than in the control group [86.72 鹵9.95 渭 g / L vs 99.24 鹵10.81 渭 g / L vs 0.31 鹵0.14) 渭 g / L vs 0.38 鹵0.11) 渭 g / L, 90.53 鹵22.32 ng / L vs 102.73 鹵20.82 ng / L, respectively. The quality of life score in the observation group was lower than that in the control group [16 鹵6 vs 24 鹵7], and the difference was statistically significant (P 0.05). Conclusion Immunotherapy with anti-tuberculosis infection can obviously relieve the clinical symptoms, improve the lung function and quality of life of the patients, and enhance the immune function of the body.
【作者單位】： 華北石油管理局總醫(yī)院結(jié)核科;華北石油管理局總醫(yī)院保健科;華北石油管理局總醫(yī)院心內(nèi)科;
【分類號(hào)】：R521
，

本文編號(hào)：1617361