CAJ | 학술논문

目的：观察胸腺肽α1辅助治疗耐药肺结核的临床疗效及其对患者免疫功能（ Th17／Treg）的影响。方法将64例耐药肺结核患者采用随机数字表法分为观察组和治疗组，每组各32例。两组均予西医抗结核药物治疗，总疗程为18个月；治疗组加予肌注胸腺肽α1针1.6 mg，2次／周，连续治疗3个月；另选健康体检者30名为对照组。比较分析观察组、治疗组的临床疗效和治疗前后两组肺部结核病灶吸收率、痰结核菌转阴率、外周血T淋巴细胞表达和药物不良反应等。结果（1）观察组、治疗组的总有效率分别为56.7％和83.3％（P＜0.05）。（2）治疗3、6个月，治疗组肺部结核病灶吸收率、痰结核菌转阴率均高于观察组，但两组治疗3个月差异无统计学意义（P＞0.05）。（3）观察组和治疗组外周血Th17、Treg和Th17／Treg较对照组明显下降（P＜0.01）；治疗3、6个月，治疗组外周血Th17、Treg和Th17／Treg较治疗前明显升高（P＜0.01），与观察组比较差异有统计学意义（ P＜0.05）。（4）观察组、治疗组不良反应发生率分别为26.6％和20.0％，差异无统计学意义（ P＞0.05）。结论胸腺肽α1辅助治疗耐药肺结核能提高临床疗效，有利于促进结核病灶吸收，增加患者的免疫功能，值得临床应用。
목적：관찰흉선태α1보조치료내약폐결핵적림상료효급기대환자면역공능（ Th17／Treg）적영향。방법장64례내약폐결핵환자채용수궤수자표법분위관찰조화치료조，매조각32례。량조균여서의항결핵약물치료，총료정위18개월；치료조가여기주흉선태α1침1.6 mg，2차／주，련속치료3개월；령선건강체검자30명위대조조。비교분석관찰조、치료조적림상료효화치료전후량조폐부결핵병조흡수솔、담결핵균전음솔、외주혈T림파세포표체화약물불량반응등。결과（1）관찰조、치료조적총유효솔분별위56.7％화83.3％（P＜0.05）。（2）치료3、6개월，치료조폐부결핵병조흡수솔、담결핵균전음솔균고우관찰조，단량조치료3개월차이무통계학의의（P＞0.05）。（3）관찰조화치료조외주혈Th17、Treg화Th17／Treg교대조조명현하강（P＜0.01）；치료3、6개월，치료조외주혈Th17、Treg화Th17／Treg교치료전명현승고（P＜0.01），여관찰조비교차이유통계학의의（ P＜0.05）。（4）관찰조、치료조불량반응발생솔분별위26.6％화20.0％，차이무통계학의의（ P＞0.05）。결론흉선태α1보조치료내약폐결핵능제고림상료효，유리우촉진결핵병조흡수，증가환자적면역공능，치득림상응용。
Objective To observe the clinical effects of the treatment of Thymosin alpha1 on drug resistant pulmonary tuberculosis, and its effects on the patients′immune function( Th17/Treg) .Methods Sixty-four patients with drug-resistant pulmonary tuberculosis were randomly divided into the observation group and the treatment group (32 cases in each group).The two groups were treated with western medicine of anti-tuberculosis drug for 18 months as a treatment course.Intramuscular injection of Thymosin alpha1 was added to the treatment group 1.6 mg per time, 2 times a week, consecutively for 3 months.30 healthy people were taken as the control group.The improvement of tuberculosis lesions, sputum negative conversion rate, peripheral blood T lymphocyte expression and the efficiency and drug adverse reactions were compared between the two groups before and after the treatment.Results ( 1 ) The total efficiency of the observation group and the treatment group were 56.7%and 83.3%( P<0.05 ) .( 2 ) The im-provement of tuberculosis lesions and sputum negative rate of the treatment group were higher than those of the obser-vation group after 3 and 6 months of the treatment.(3) Th17, Treg and Th17/Treg in the peripheral blood of the two groups were decreased significantly compared with the control group(P<0.01).Th17, Treg and Th17/Treg in the peripheral blood of the treatment group were increased significantly after 3 and 6 the months of the treatment compared with those before the treatment(P<0.01).There was significant difference between the two groups(P<0.05).(4) The incidences of adverse reaction of the observation group and the treatment group were 26.6% and 20%( P>0.05 ) .Conclusion Thymosin alpha1 can increase the patients′immune function and improve the X-ray and clinical efficacy in treatment of drug resistant tuberculosis.