标题：胸腺五肽联合抗结核药治疗复治涂阳肺结核疗效观察

      作者：杨才勇 1，李奎 1，江自成 1，卜蓉蓉 2    安康市中心医院感染性疾病科 1、呼吸内科 2，陕西 安康 725000

      卷次： 2019年30卷19期

      【摘要】 目的 探讨胸腺五肽联合抗结核药治疗复治涂阳肺结核的临床疗效。方法 选择 2017年 1月至2018年8月期间安康市中心医院收治的90例复治涂阳肺结核患者为研究对象，根据随机数表法分为对照组和观察组，每组45例，对照组患者接受2 (HZE+Mfx+ Rfb)/6 (HE+Rfb)方案化疗，观察组则在对照组治疗的基础，在强化期(2个月)联合应用胸腺五肽治疗，总疗程8个月。比较两组患者治疗前及治疗2个月后T淋巴细胞亚群(包括CD3+、CD4+、CD8+及CD4+/CD8+)水平；疗程结束后评价痰菌转阴率及病灶吸收情况。结果 治疗2个月后，观察组患者血CD3+、CD4+及CD4+/CD8+分别为(59.4±5.2)%、(36.8±3.7)%、1.36±0.41，与治疗前比较，有明显升高，且高于治疗后对照组的(53.3±4.5)%、(33.4±4.2)%、1.21±0.37，差异均有统计学意义(P<0.05)；疗程结束后，观察组患者痰菌转阴率及病灶明显吸收率分别为86.67%和84.44%，均明显高于对照组的62.22%和62.22%，差异均有统计学意义(P<0.05)。结论 抗结核药物联合胸腺五肽治疗复治涂阳肺结核患者可以明显提高患者的免疫功能，促进痰菌的转阴及病灶的吸收，具有确切的疗效。
      【关键词】 结核病；复治涂阳肺结核；胸腺五肽；抗结核药物；免疫功能；疗效
      【中图分类号】 R521 【文献标识码】 A 【文章编号】 1003—6350（2019）19—2539—03

Therapeutic outcome of thymopentin combined with anti-tuberculosis drugs on retreated smear-positivepulmonary tuberculosis.
YANG Cai-yong 1, LI Kui 1, JIANG Zi-cheng 1, BO Rong-rong 2. Department of InfectiousDiseases 1, Department of Respiratory Medicine 2, Ankang Central Hospital, Ankang 725000, Shaanxi, CHINA
【Abstract】 Objective To investigate the clinical efficacy of thymopentin plus anti-tuberculosis drugs in thetreatment of retreated smear-positive pulmonary tuberculosis. Methods Ninety patients of retreated smear-positive pul-monary tuberculosis treated in Ankang Central Hospital from January 2017 to August 2018 were selected as the researchobjects. According to random number table method, the patients were divided into the control group and observationgroup, with 45 patients in each group. The control group received 2 (HZE+ Mfx+ Rfb)/ 6 (HE+Rfb) regimen chemother-apy, while the observation group received thymopentin treatment in the intensive phase (2 months), both for 8 months.The levels of T lymphocyte subsets (including CD3+, CD4+, CD8+, CD4+/CD8+) were compared between the two groupsbefore treatment and 2 months after treatment. The sputum negative conversion rate and lesion absorption were evaluat-ed after treatment. Results After 2 months of treatment, the levels of CD3 + , CD4 + , CD4 +/ CD8 + in the observationgroup were (59.4±5.2)%, (36.8±3.7)%, 1.36±0.41, respectively, which were not only significantly higher than those be-fore treatment, but also significantly higher than corresponding (53.3±4.5)%, (33.4±4.2)%, 1.21±0.37 in the controlgroup (all P<0.05). After the treatment, the sputum negative conversion rate and the absorption rate of focus in the obser-vation group were respectively 86.67% and 84.44% , which were significantly higher than corresponding 62.22% and62.22% in the control group which (P<0.05). Conclusion Antituberculosis drugs combined with thymopentin can sig-nificantly improve the immune function of patients with retreated smear-positive pulmonary tuberculosis, promote thenegative transformation of sputum bacteria and the absorption of focus, and have definite curative effect.
      【Key words】 Tuberculosis; Retreated smear-positive pulmonary tuberculosis; Thymopentin; Antituberculosisdrugs; Immune function; Curative effect·短篇论著·doi:10.3969/j.issn.1003-6350.2019.19.027