【摘要】 目的观察3HRZE/6HRE方案联合左氧氟沙星、胸腺肽α1治疗肺结核的临床疗效,探讨其对血清降钙素原(PCT)和可溶性髓系细胞触发受体1(s TREM-1)水平的影响。方法选取2013年5月—2015年5月在常德市第一人民医院接受治疗的肺结核患者76例,采用随机数字表法分为对照组和观察组,每组38例。对照组患者给予3HRZE/6HRE方案治疗,观察组患者在对照组治疗基础上给予左氧氟沙星和胸腺肽α1治疗;两组患者均连续治疗9个月。比较两组患者临床疗效,治疗3、6个月末痰菌转阴率和病灶吸收情况,治疗前和治疗6个月后血清PCT和sTREM-1水平,并观察治疗期间两组患者不良反应发生情况。结果观察组患者临床疗效优于对照组(P<0.05)。治疗3、6个月末观察组患者痰菌阴转率均高于对照组,病灶吸收情况均优于对照组(P<0.05)。治疗前两组患者血清PCT、sTREM-1水平比较,差异无统计学意义(P>0.05);治疗后观察组患者血清PCT、sTREM-1水平低于对照组(P<0.05)。治疗期间两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论 3HRZE/6HRE方案联合左氧氟沙星、胸腺肽α1治疗肺结核的临床疗效确切,能有效促进患者痰菌转阴和病灶吸收,降低血清PCT和sTREM-1水平,且安全性较高。更多还原

【Abstract】 Objective To observe the clinical effect of 3HRZE/6HRE scheme combined with levofloxacin and thymosin α₁ on pulmonary tuberculosis, to investigate the impact on serum levels of procalcitonin（PCT） and sTREM-1.Methods A total of 76 patients with pulmonary tuberculosis were selected in the First People’ s Hospital of Changde from May2013 to May 2015,and they were divided into control group and observation group according to random number table,each of 38 cases. Patients of control group received 3HRZE/6HRE scheme, while patients of observation group received 3HRZE/6HRE scheme combined with levofloxacin and thymosin α₁; both groups continuously treated for 9 months. Clinical effect,sputum negative conversion rate and lesions absorption results after 3 and 6 months of treatment,serum levels of PCT and sTREM-1 before treatment and after 6 months of treatment were compared between the two groups,and incidence of adverse reactions was observed during the treatment. Results Clinical effect of observation group was statistically significantly better than that of control group（P < 0. 05）. After 3 and 6 months of treatment,sputum negative conversion rate of observation group was statistically significantly higher than that of control group, respectively, meanwhile lesions absorption results of observation group were statistically significantly better than those of control group（P < 0. 05）. No statistically significant differences of serum level of PCT or sTREM-1 was found between the two groups before treatment（P > 0. 05）,while serum levels of PCT and sTREM-1 of observation group were statistically significantly lower than those of control group after treatment（P < 0. 05）. No statistically significant differences of incidence of adverse reactions was found between the two groups during the treatment（P > 0. 05）.Conclusion 3HRZE/6HRE scheme combined with levofloxacin and thymosin α₁ has certain clinical effect in treating pulmonary tuberculosis,can effectively promote the sputum negative conversion and lesions absorption,reduce the serum levels of PCT and sTREM-1,with relatively high safety.更多还原