标题：胸腺五肽联合常规抗结核化疗方案在复治涂阳肺结核治疗中的应用

      作者：刁利霞 1，吴宇平 2，邓俊亮 3    1.江门市新会区人民医院感染性疾病科，广东 江门 529100；2.江门市新会区中医院葵湖院区综合内科一区，广东 江门 529100；3.江门市新会区人民医院呼吸与危重症医学科二区，广东 江门 529100

      卷次： 2021年32卷7期

      【摘要】 目的 探讨胸腺五肽联合常规抗结核化疗方案在复治涂阳肺结核治疗中的应用价值。方法 选择新会区人民医院于2015年4月至2019年10月期间收治的184例复治涂阳肺结核患者为研究对象，根据随机数表法将患者分为观察组和对照组，每组92例，对照组患者接受左氧氟沙星+3HRZE/6HRE方案治疗，观察组患者在对照组基础上联合应用胸腺五肽3个月，总疗程均为9个月。比较治疗前及总疗程结束后，两组患者的血清肿瘤坏死因子-α (TNF-α)、白细胞介素-4 (IL-4)、干扰素-γ (IFN-γ)水平，并在治疗后记录并比较两组患者的痰菌转阴率、病灶吸收率和空洞闭合缩小率。结果 治疗前，两组患者的血清TNF-α、IL-4及 IFN-γ水平比较差异均无统计学意义(P>0.05)；治疗后，观察组患者的血清TNF-α、IL-4及 IFN-γ水平分别为(43.56±12.33) ng/mL、(13.23±3.71) ng/mL、(26.38±5.24) ng/mL，明显低于对照组的(65.73±18.36) ng/mL、(21.87±5.32) ng/mL、(19.23±4.32) ng/mL，且两组患者上述指标均明显低于治疗前，差异均有统计学意义(P<0.05)；治疗后，观察组患者的痰菌转阴率、病灶吸收率及空洞闭合缩小率分别为89.13%、79.35%、78.26%，明显高于对照组的76.09%、66.30%、60.87%，差异均有统计学意义(P<0.05)。结论 胸腺五肽联合常规化疗应用于复治涂阳肺结核能显著提高标准化疗的疗效，这与胸腺五肽能降低患者血清炎性因子、提高免疫功能等机制有关。
      【关键词】 肺结核；复治肺结核；胸腺五肽；免疫功能；疗效
      【中图分类号】 R521 【文献标识码】 A 【文章编号】 1003—6350（2021）07—0892—03

Application value of thymopentin combined with conventional anti-tuberculosis chemotherapy in retreatedsmear-positive pulmonary tuberculosis.
DIAO Li-xia 1, WU Yu-ping 2, DENG Jun-liang 3. 1. Department of InfectiousDiseases, Jiangmen Xinhui District People's Hospital, Jiangmen 529100, Guangdong, CHINA; 2. First Ward of Departmentof Comprehensive Internal Medicine Kuihu Branch, Jiangmen Xinhui District Hospital of Traditional Chinese Medicine,Jiangmen 529100, Guangdong, CHINA; 3. Second Ward of Department of Respiratory and Critical Care Medicine, JiangmenXinhui District People's Hospital, Jiangmen 529100, Guangdong, CHINA
【Abstract】 Objective To investigate the application value of thymopentin combined with conventional anti-tu-berculosis chemotherapy in retreated smear-positive pulmonary tuberculosis. Methods A total of 184 retreatedsmear-positive pulmonary tuberculosis patients treated in Jiangmen Xinhui District People's Hospital from April 2015 toOctober 2019 were selected and divided into the observation group and control group according to random number tablemethods, with 92 patients in each group. The control group received levofloxacin +3HRZE/6HRE, and the observationgroup was treated with thymopentin (3 months) on that basis. The course of treatment lasted 9 months. The levels of se-rum TNF-α, IL-4 and IFN-γ in the two groups were compared before and after treatment, and the sputum negative con-version rate, lesion absorption rate and cavity closure reduction rate of the two groups were recorded and compared aftertreatment. Results Before treatment, there was no significant difference in TNF-α, IL-4 and IFN-γ between the twogroups (P>0.05); after treatment, the serum TNF-α, IL-4, and IFN-γ in the observation group were (43.56±12.33) ng/mL,(13.23±3.71) ng/mL, and (26.38±5.24) ng/ mL, respectively, which were significantly lower than corresponding (65.73±18.36) ng/mL, (21.87±5.32) ng/mL, (19.23±4.32) ng/mL in the control group, and the above indexes of the two groupswere significantly lower than those before treatment (all P<0.05); after treatment, the sputum negative conversion rate, fo-cus absorption rate, and cavity closure reduction rate of the observation group were 89.13%, 79.35%, and 78.26%, respec-tively, which were significantly higher than corresponding 76.09%, 66.30%, and 60.87% of the control group (all P<0.05).Conclusion For retreated smear-positive pulmonary tuberculosis, thymopentin combined with conventional anti-tubercu-losis chemotherapy can significantly improve the efficacy of standard chemotherapy, which is related to the mechanismthat thymopentin can reduce serum inflammatory factors and improve immune function.
      【Key words】 Pulmonary tuberculosis; Retreated pulmonary tuberculosis; Thymopentin; Immune function; Cura-tive effect·短篇论著·doi:10.3969/j.issn.1003-6350.2021.07.020