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重组人白细胞介素-2辅助治疗复治肺结核近期疗效观察

A controlled clinical study on the efficacy of recombinant human interleukin-2 in the treatment of pulmonary tuberculosis

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【作者】 初乃惠朱莉贞叶志忠苑松林王静云许家琏马丽萍

【Author】 CHU Nai-hui , ZHU Li-zhen,YIE Zhi-zhong,YUAN Song-lin,WANG Jing-yun,XU Jia-lian,MA Li-ping. Beijing Institute of Tuberculosis and Thoracic Tumor, Beijing 101149, China

【机构】 北京市结核病胸部肿瘤研究所厦门市第二医院天津市肺科医院沈阳市胸科医院上海市肺科医院北京市结核病胸部肿瘤研究所 101149101149

【摘要】 目的 研究和评价重组人白细胞介素 2 (IL 2 )辅助治疗肺结核病的疗效。方法 将 2 0 9例复治菌阳肺结核患者 ,采用计算机随机分组方法分为 :治疗组 10 6例 ,采用 3PaZ(TH)L2 VE(AK) +IL 2 / 4PaL2 V方案化疗 (Pa :力克肺疾 ,Z :吡嗪酰胺 ,TH :丙硫异烟胺 ,L :利福喷汀 ,V :左氧氟沙星 ,AK :阿米卡星 ,E :乙胺丁醇 ) ;对照组 10 3例 ,采用 3PaZ(TH)L2 VE(AK) / 4PaL2 V方案进行短程化疗。结果 完成疗程可评价疗效者 2 0 3例 ,其中治疗组 10 3例 ,对照组 10 0例。治疗第 1、2个月治疗组和对照组痰菌阴转率分别为 33 3%、7 2 %和 6 9 4 %、4 4 9% ,差异有非常显著性意义 (P <0 0 1)。治疗结束时治疗组和对照组显效率分别为 6 4 1%和 36 0 % ,差异有非常显著性意义 (P <0 0 0 1)。治疗组治疗 3和 7个月时CD4、CD4/CD8和NK细胞较对照组提高 ,差异有非常显著性意义 (P <0 0 1)。治疗 3个月时治疗组IL 2可溶性受体 (sIL 2R)较对照组降低 ,两组比较差异有显著性 (P <0 0 5 )。无严重不良反应发生。结论 重组人IL 2可辅助治疗肺结核 ,是一种安全、可靠的生物制剂。

【Abstract】 Objective To study and evaluate the efficacy and safety of recombinant human interleukin -2(IL-2) in the treatment of pulmonary tuberculosis. Methods Two hundred and nine cases with re-treated Mycobacterium tuberculosis -positive pulmonary tuberculosis were randomly divided into a trial group (106 cases, treated with 3PaZ(TH)L2VE(AK)+IL-2/4PaL2V) and a control group (103 cases, treated with 3PaZ(TH)L2VE(AK)/4PaL2V). The efficacy of 203 cases was available for evaluation when the course was completed (trial group 103 cases, control group 100 cases). Results The sputum smear-negative conversion rates at the 1st and the 2nd month of therapy were 33.3% and 69.4% in the trial group, and 7.2% and 44.9% in the control group ( P< 0.01). At the completion of the therapy, the X-ray resolution rates were 64.1% and 36.0% respectively for the trial and the control groups, the difference being significant ( P< 0.001). There were significant differences in CD4 T cells, the ratio of CD4/CD8 and NK cells between the two groups ( P< 0.01). The level of soluble interleukin-2 receptor (sIL-2R)was significantly different between the two groups after treatment for 3 months ( P< 0.05). IL-2 associated side effects were rare and mild. Conclusion As an effective and relatively safe biological agent, IL-2 can be added to the standard chemotherapy for pulmonary tuberculosis.

  • 【文献出处】 中华结核和呼吸杂志 ,Chinese Journal of Tuberculosis and Respiratory Diseases , 编辑部邮箱 ,2003年09期
  • 【分类号】R521
  • 【被引频次】25
  • 【下载频次】353
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