摘要
目的:探讨口服及胸腔注射糖皮质激素对结核性胸膜炎患者血清和胸腔积液γ干扰素(IFN-γ)、炎性因子、免疫功能的影响及其临床疗效。方法:选取2016年2月-2018年4月来本院诊治的82例结核性胸膜炎患者作为研究对象,参照随机数字表法分为口服给药组和胸腔注射给药组,每组41例。口服给药组给予口服强的松治疗,胸腔注射给药组给予注射地塞米松治疗。观察两组用药前后外周血和胸腔积液中IFN-γ、炎性因子白细胞介素-6(IL-6)、白细胞介素-8(IL-8)和可溶性白细胞介素2受体(SIL-2R)水平变化情况,1个月后比较两组的临床疗效。结果:用药前,两组患者血清和胸腔积液中IFN-γ、IL-6、IL-8、SIL-2R水平比较,差异均无统计学意义(P>0.05)。用药后,胸腔注射给药组患者胸腔积液中IFN-γ水平显著低于用药前,且低于口服给药组,差异均有统计学意义(P<0.05);用药后,口服给药组血清中IFN-γ水平显著低于用药前,且低于胸腔注射给药组,差异均有统计学意义(P<0.05)。用药后,胸腔注射给药组患者胸腔积液中IL-6、IL-8水平均显著低于用药前,且均低于口服给药组,胸腔积液中SIL-2R水平显著高于用药前,且明显高于口服用药组,差异均有统计学意义(P<0.05);用药后,口服给药组血清中IL-6、IL-8水平均显著低于用药前,且均低于胸腔注射给药组,血清SIL-2R水平显著高于用药前,且明显高于胸腔注射给药组,差异均有统计学意义(P<0.05)。治疗1个月后,胸腔注射给药组患者的临床总有效率为95.1%,高于口服给药组的73.2%,差异有统计学意义(P<0.05)。结论:与口服糖皮质激素比较,胸腔注射糖皮质激素能有效抑制胸膜腔内细胞免疫功能,抑制胸膜腔局部的免疫因子表达,减弱对整个机体的免疫抑制作用,对结核性胸膜炎起到更少副作用、更好效果,值得临床上进一步应用推广。
Objective:To explore the effects of oral and thoracic injection of glucocorticoid on the immune function of inflammatory factors in serum and pleural effusion of IFN-γ in patients with tuberculous pleurisy and its clinical efficacy.Method:From February 2016 to April 2018,82 patients with tuberculous pleurisy treated in our hospital were selected,according to the random number table method,they were divided into oral administration group and intrathoracic injection group,41 cases in each group.The oral administration group was treated with oral Prednisone,the intrathoracic injection group was treated with Dexamethasone injection.Changes in inflammatory factor(IFN-γ),interleukin-6(IL-6),interleukin-8(IL-8) and soluble interleukin-2 receptor(SIL-2 R) levels in peripheral blood and pleural effusion were observed before and after administration,the clinical efficacy of the two groups was compared after 1 month.Result:Before taking the drug,the levels of IFN-γ,IL-6,IL-8,SIL-2 R in serum and pleural effusion of the two groups were compared,the differences were not statistically significant(P>0.05).After taking the drug,the level of IFN-γ in the pleural effusion of the patients in the thoracic injection group was significantly lower than that before taking the drug and oral administration group,the differences were statistically significant(P<0.05).After taking the drug,the level of IFN-γ in serum of the oral administration group was significantly lower than that before taking drug and thoracic injection group,the differences were statistically significant(P<0.05).After taking the drug,the levels of IL-6,IL-8 in pleural effusion of the thoracic injection group were significantly lower than those of the oral administration group,and the level of SIL-2 R in pleural effusion was significantly higher than that of the oral administration group,the differences were statistically significant(P<0.05).After the administration,the serum levels of IL-6,IL-8 in the oral administration group were significantly lower than those o
作者
刘子林
何佩娟
章玉坤
LIU Zilin;HE Peijuan;ZHANG Yukun(Jiangxi Provincial Chest Hospital,Nanchang 330000,China)
出处
《中国医学创新》
CAS
2018年第35期36-39,共4页
Medical Innovation of China
基金
江西省卫生计生委中医药科研课题项目(2015A147)
关键词
结核性胸膜炎
Γ干扰素
炎性因子
免疫功能
糖皮质激素
Tuberculous pleurisy
Interferonγ
Inflammatory factors
Immune function
Glucocorticoid
