摘要
目的探讨γ-干扰素联合微卡辅助抗结核治疗的疗效及免疫机制。方法160例肺结核患者随机分为四组：基础用药组、γ-干扰素组、微卡组及联合组，每组40例。基础用药：所有病例均采用标准短程化疗（2HRETM4HR），各干预组均给予相应的药物，观察各组2个月末痰菌阴转和病灶吸收情况，治疗前和2个月末用APAAP法检测患者外周血T细胞亚群CD4＋、CD8＋比例，同时用ELISA法检测患者外周血IFN-1和IL-4含量。结果与基础用药组比较，γ-干扰素组、微卡组、联合组痰菌阴转率明显升高（P〈0．05）；与γ-干扰素组、微卡组比较，联合组痰菌阴转率差异无统计学意义（P〉0．05）；与基础用药组比较，γ-干扰素组、微卡组、联合组病灶吸收显效率增加（P〈0．05）；与γ-干扰素组、微卡组比较，联合组病灶吸收显效率更明显（P〈0．05）。γ-干扰素组、微卡组、联合组外周血T细胞亚群CD4＋比例和IFN-γ含量变化值均显著高于基础用药组（P〈0．05）；与γ-干扰素组、微卡组比较，联合组变化值增高更显著（P〈0．05）。γ-干扰素组、微卡组、联合组外周血T细胞亚群CD8＋比例和IL4含量变化值显著低于基础用药组（P〈0．05）；与γ-干扰素组、微卡组比较，联合组变化值降低更显著（P〈0．05）。结论γ-干扰素和微卡能改善肺结核患者的细胞免疫功能。有助于痰菌转阴。促进病灶吸收，增强化疗疗效，是较好的结核病免疫治疗制剂，且两者联用具有协同作用。
Objective To investigate the clinical effect and immune mechanism of IFN-γand M. vaccae combined with conventional anti-tubemulosis drug. Methods 160 cases of pulmonary tuberculosis were equally random divided into groups： base group, IFN-γgroup, M vaccae group, IFN-γ ＋ M vaccae group. All group were treated with conventional anti-tuberculosis drug. The IFN group was treated with corresponding medicines. After two months treatment, X ray manifestation and sputum conversion were observed, the rates of CD4 ＋, CD8 ＋ cells in blood were measured by APAAP, the levels of IFN-Tand IL-4 in blood were measured by ELISA. Results Compared with base group, there was significantly difference of sputum conversion rate in IFN-γgroup and M vaccae group（ P 〈0. 05）, but the sputum conversion rate in IFN-γ ＋ M vaccae group showed no significant difference as compared with the other two groups （ P 〉 0. 05 ）. Compared with base group, X ray manifestation and the rates of CD4 ＋ cells in blood and the levels of IFN-γwere higher in the three treated groups （ P 〈 0. 05 ）, X ray manifestation and the rates of CD8 ＋ cells in blood and the levels of IL-4 were lower in the three treated groups （ P 〈 0. 05 ）, particularly in the IFN-γ ＋ M vaccae group showed a significant difference as compared with the other two groups （ P 〈 0. 05）. Condusion As adjunct to chemotherapy, IFN-γand M. vaccae are helpful for patients with pulmonary tuberculosis by improving the cell medicated immunity, sputum negative conversion and X ray manifestation. They are good iannunoregulator and have cooperative effect in the treatment of pulmonary tuberculosis.
出处
《中国医师杂志》
CAS
2008年第2期183-185,共3页
Journal of Chinese Physician
