摘要
目的探讨规范化治疗方案在初治涂阳肺结核治疗中的效果。方法选取2015—2017年在本院治疗的初治涂阳肺结核患者302例,根据患者选取的治疗方案分为观察组(n=171)和对照组(n=131),对照组给予常规方案治疗,观察组在对照组基础上加用规范化管理,观察两组痰涂片阴转、病灶吸收、空洞变化等,同时检测治疗前后白细胞介素-17(IL-17)和干扰素-γ(IFN-γ)水平。结果观察组治疗3、4、6个月末痰涂片转阴率分别为90.64%、94.74%和98.25%,病灶吸收有效率达100.00%,空洞闭合和缩小比例达到94.74%,以上各指标均优于对照组,差异均有统计学意义(P值均<0.05);治疗后3个月IL-17为(23.38±3.52)ng/L,低于对照组(P<0.05),而IFN-γ为(46.69±7.22)pg/mL,高于对照组(P<0.05);观察组肝功异常、血常规异常发生比例分别为9.36%和4.68%,均低于对照组(P值均<0.05)。结论在四联方案基础上给予患者加用规范化治疗方案,在初治涂阳肺结核治疗中有较好的效果,值得临床推广。
Objective To explore the effect of standardized treatment in the treatment of smear-positive pulmonary tuberculosis.Methods A total of 302 cases of smear-positive pulmonary tuberculosis patients treated in our hospital from 2015 to2017 were selected,who were divided into observation group(n=171)and control group(n=131);the control group was treated with conventional scheme while the observation group was additionally treated with standardized management based on the control group treatment.The sputum smear negative transformation,lesion absorption and cavity changes were observed,and the levels of interleukin-17(IL-17)and interferon-γ(IFN-γ)were determined and compared before and after treatment.Results At the end of 3,4 and 6 months after treatment,the negative conversion rate of sputum smear in observation group were 90.64%,94.74%and 98.25%,respectively;the effective absorption rate of lesions was 100.00%;the ratio of cavity closure and reduction was 94.74%;all above indexes were higher than those of the control group,and the differences were statistically significant(all P<0.05).Three months after treatment,IL-17 level of observation group was(23.38±3.52)ng/L,which was lower than that of the control group(P<0.05);while IFN-γlevel of observation group was(46.69±7.22)pg/mL,which was higher than that of the control group(P<0.05);The percentage of abnormal liver function and blood routine of observation group were 9.36%and 4.68%,respectively;which were lower than those of control group(all P<0.05).Conclusion The additional standardized treatment scheme based on conventional scheme has a good effect in the treatment of initial smear-positive pulmonary tuberculosis,which is worthy of clinical use.
作者
吴素方
郑淑兰
刘新
梁丽丽
WU Su-Fang;ZHENG Shu-lan;LIU Xing;LIANG Li-li(Henan Thoracic Hospital,Henan Zhengzhou 450003,China)
出处
《江苏预防医学》
CAS
2019年第4期367-369,共3页
Jiangsu Journal of Preventive Medicine
基金
2015年度河南省重点科技攻关项目“缩短敏感肺结核治疗疗程的研究”(152102310152)
关键词
规范化治疗方案
初治涂阳
肺结核
临床效果
Standardized treatment scheme
Initial smear positive
Tuberculosis
Clinical effect
