【作者】 谭守勇； 吴碧彤； 林兆原； 黎燕琼；

【Author】 Tan Shouyong,Wu Bitong,Lin Zhaoyuan,Li Yanqiong Guangzhou Chest Hospital,tuberculosis typical department,510095,China

【机构】 广州市胸科医院；

【摘要】 目的:进一步探讨免疫干预治疗对老年肺结核细胞免疫及低蛋白血症影响。方法:采用前瞻性研究方法,将80例老年初治菌阳肺结核患者随机分入化疗联合母牛分枝杆菌菌苗的治疗组和单纯化疗的对照组各40例;同时,分别在治疗前、治疗2个月末和6个月末观察其外周血T淋巴细胞亚群、血清白蛋白、痰抗酸杆菌涂片及培养。结果:(1)治疗组治疗2月末后CD4~+T淋巴细胞显著升高、CD8~+T淋巴细胞显著下降和CD4~+/CD8~+T淋巴细胞比值明显升高(P<0.05);而治疗6月末与2月末比较变化不大(P>0.05);对照组治疗前、治疗2月末及治疗6月末CD4~+T、CD8~+T淋巴细胞和CD4~+/CD8~+T淋巴细胞比值变化不大(P>0.05)。(2)治疗组和对照组治疗2月末其血清白蛋白均得到提高(P<0.01和P<0.05),有统计学意义。其次,治疗组治疗前低蛋白血症(<35g/L)27例(67.5%),而对照组为24例(60.0%);治疗2月末治疗组和对照组其低蛋白血症分别为11例(27.5%)和20例(50.0%)(P<0.05)。(3)治疗组治疗2月末痰菌阴转率明显较对照组高,有明显统计学意义(P<0.05)。结论:初治老年肺结核病患者采用免疫干预治疗,提高患者的CD4~+淋巴细胞免疫功能,改善低蛋白血症,提高治疗2月末痰菌阴转率。更多还原

【Abstract】 Objective:To evaluate the effect of cellar immunity and hypoproteinemia on the initial treatment of the elder patients with pulmonary tuberculosis by mycobacterium vaccae combined chemotherapy.Methods:80 cases of initially treated elderly pulmonary tuberculosis with smear and culture positive were divided into treatment group with M.vaccae vaccine adjuvant therapy and control group at random pair,in this study with the way of prospective cohort.All patients were checked before and after treatment(at the end of 2,6months),by T lymphocyte subsets,serum albumin,sputum and culture for tuberculosis.Results:(1)CD4~+ T lymphocyte percentages,CD4~+/CD8~+ ratio were significantly higher and CD8~+ T lymphocyte percentages were significantly lower at the end of 2 months after treatment in the treatment group(P<0.05). There were no differences between 2 and 6 months after treatment(P>0.05).CD4~+、CD8~+ lymphocyte percentages and CD4~+/CD8~+ ratio were no difference between pre-freatment and post-treatment in control group(P>0.05).(2)The serum albumin were increased at the end of 2 months in two groups(P<0.01和P<0.05).(3)The conversion rate of the sputum negative at the end of 2 months has significantly differences between treatment and control groups(P<0.05). Conclusions:The cellar immunity on the initial treatment of the elder patients with pulmonary tuberculosis by immunity interfere treating was increased;the hypoproteinemia was improved and the conversion rate of the sputum negative at the end of 2 months was gone up.更多还原