CAJ | 학술논문

[目的]探讨血清可溶性白介素-2受体（sIL-2R）水平在耐多药肺结核（MDR-TB）患者中的表达及白介素-2（IL-2）治疗MDR-TB的疗效。[方法]检测126例MDR-TB患者sIL-2R水平，并与60例健康体检者（对照组）比较。126例MDR-TB患者分为两组，B组根据药敏结果选择4种以上抗结核药物组成联合治疗方案，总疗程为24个月，A组在B组基础上最初6个月加用IL-2，观察两组患者血清sIL-2R水平下降情况、痰菌阴转率、空洞好转率和远期复发率。[结果]MDR-TB组sIL-2R水平升高，显著高于对照组（P＜0．05），治疗过程中sIL-2R水平随病情好转逐渐下降；疗程结束时，两组痰菌阴转率、空洞缩小或闭合率比较均有显著性差异（P＜0．05）；随访18个月A组痰菌复阳率显著低于B组（ P ＜0．05）。[结论]检测肺结核病患者血清sIL-2R水平可作为患者病情变化、预后判断的重要指标；MDR-TB患者存在免疫功能低下，采用中等剂量IL-2长程间歇治疗，副反应较轻，可明显改善机体的免疫功能，提高疗效及降低远期复发率。
[목적]탐토혈청가용성백개소-2수체（sIL-2R）수평재내다약폐결핵（MDR-TB）환자중적표체급백개소-2（IL-2）치료MDR-TB적료효。[방법]검측126례MDR-TB환자sIL-2R수평，병여60례건강체검자（대조조）비교。126례MDR-TB환자분위량조，B조근거약민결과선택4충이상항결핵약물조성연합치료방안，총료정위24개월，A조재B조기출상최초6개월가용IL-2，관찰량조환자혈청sIL-2R수평하강정황、담균음전솔、공동호전솔화원기복발솔。[결과]MDR-TB조sIL-2R수평승고，현저고우대조조（P＜0．05），치료과정중sIL-2R수평수병정호전축점하강；료정결속시，량조담균음전솔、공동축소혹폐합솔비교균유현저성차이（P＜0．05）；수방18개월A조담균복양솔현저저우B조（ P ＜0．05）。[결론]검측폐결핵병환자혈청sIL-2R수평가작위환자병정변화、예후판단적중요지표；MDR-TB환자존재면역공능저하，채용중등제량IL-2장정간헐치료，부반응교경，가명현개선궤체적면역공능，제고료효급강저원기복발솔。
[Objective] To explore the expression of serum soluble interleukin-2 receptor(SIL-2R) in patients with multidrug resistant tuberculosis (MDR-TB) and the efficacy of interleukin-2(IL-2) for the treatment of MDR-TB .[Meth-ods] The level of SIL-2R in 126 patients with MDR-TB was measured and compared with 60 healthy subjects (control group) .All 126 MDR-TB patients were divided into two groups .According to the drug susceptibility results ,the combi-nation regimens were composed of more than 4 different antituberculosis drugs . The total treatment course was 24 months .Group A was additionally given IL-2 at the first 6 months .The decreasing of serum SIL-2R levels ,sputum neg-ative conversion rate ,hollow improvement rate and long-term relapse rate of two groups were observed .[Results]SIL-2R in MDR-TB group was increased and significantly higher than that in control group ( P <0 .05) .During the treatment , SIL-2R was gradually reduced with the improvement of illness state .There was significant difference in sputum negative conversion rate and hollow diminution or closure rate at the end of treatment course between two groups ( P <0 .05) . During the 18 months of follow up ,sputum re-positive rate in group A was significantly lower than that in group B ( P<0 .05) .[Conclusion]Serum SIL-2R in tuberculosis patients can be used as an important indicator for assessing the change of illness state and prognosis .Patients with MDR-TB have low immune function and should be given long-term intermit-tent treatment with medium dose of IL-2 ,which has light side effects and can improve immune function of patients ,in-crease the efficacy and reduce long-term recurrence rate .