【摘要】 目的:观察脊柱结核抗结核治疗效果与结核感染T细胞检测反应强度的关系。方法:选取本院2015年2月至2017年12月住院治疗的脊柱结核病人,按照TB-IGRA检查结果(80～400 pg/mL)纳入试验组,入院常规抗结核治疗2周后根据TB-IGRA复查结果分为A组(下降≥50 pg/mL)和B组(下降<50 pg/mL)。2周后所有患者均行常规手术治疗,术后2周再次复查A,B两组,下降≥50 pg/mL为A1组(A组)和B1组(B组),下降<50 pg/mL为A2组(A组)和B2组(B组)。手术6个月后分别将A1A2两组、B1B2两组及AB两组之间的脊柱植骨融合时间、结核复发率和愈合率进行比较,观察TB-IGRA值与脊柱结核疗效之间的关系。结果:所有患者均获得6个月以上的随访,植骨融合时间比较:A组和B组植骨融合时间为(5.73±1.24)个月和(7.81±1.95)个月,A1组与A2组为(5.04±1.56)个月和(6.85±1.81)个月,B1组与B2组为(7.12±1.72)个月与(8.90±1.42)个月,组间比较差异均有统计学意义(P<0.05)。术后复发率比较:A组复发率为15%,B组为12.5%,A1,A2组及B1,B2组复发率分别为10%,10%及20%,15%,三组差异无统计学意义(P>0.05)。术后治愈率比较:A组,B组治愈率分别为85%,77.5%,A1,A2组,B1及B2组治愈率分别为90%,85%,80%及70%,三组差异均有统计学意义(P<0.05)。结论:脊柱结核抗结核治疗效果与结核感染T细胞检测反应强度有一定的相关性,对于临床抗结核治疗的方案选择和调整具有指导意义。更多还原

【Abstract】 Objective: To observe the relationship between the anti-tuberculosis effect of spinal tuberculosis and the response intensity of T cells in tuberculosis infection.Methods:Patients with spinal tuberculosis hospitalized in our hospital from February 2015 to December 2017 were enrolled in the experimental group according to the results of TB-IGRA(400 pg/mL≥N≥80 pg/mL).After two weeks of routine anti-tuberculosis treatment, patients were divided into group A(N value decreased more than 50 pg/mL) and group B(N value decreased less than 50 pg/mL) according to the results of TB-IGRA reexamination.Two weeks later, all patients were treated with routine surgery.Two weeks after operation, the N values of A and B groups were re-examined.The N values decreased more than 50 pg/mL in group A1 and B1, and the N values decreased less than 50 pg/mL in group A2 and group B2.Six months after operation, the fusion time, recurrence rate and healing rate of spinal bone graft between A1 A2 group, B1 B2 group and AB group were compared, and the relationship between TB-IGRA value and curative effect of spinal tuberculosis was observed.Results: All patients were followed up for more than 6 months.The time of bone graft fusion in group A and B was(5.73±1.24) months and(7.81±1.95) months,(5.04±1.56) months and(6.85±1.81) months in group A1 and group A2,(7.12±1.72) months and(8.90±1.42) months in group B1 and group B2,with P<0.05 in each group.The recurrence rate was 15% in group A and 12.5% in group B.The recurrence rates in group A1, A2, B1 and B2 were 10%, 10%, 20% and 15%.This three groups was no significant difference.Last, the cure rates of group A and B, A1 and A2, B1 and B2 were 85% and 77.5%,90% and 85%, 80% and 70%.Which also had significant differences among this three groups(P<0.05).Conclusion:The therapeutic effect of anti-tuberculosis treatment of spinal tuberculosis is correlated with the response intensity of T cell detection of tuberculosis infection, which is of guiding significance for the selection and adjustment of clinical anti-tuberculosis treatment.更多还原