利福平的血药浓度对复治涂阳肺结核患者免疫细胞的影响

目的：分析复治涂阳肺结核患者的利福平血药浓度对机体免疫细胞的影响。方法选取住院及门诊确诊为复治涂阳肺结核病患者80例为研究对象，采用治疗方案3HRZE／6HRE常规化疗。对比治疗前及强化期结束后患者机体免疫细胞CD4＋T淋巴细胞、CD8＋T淋巴细胞、调节性T细胞、骨髓来源抑制性细胞（ MDSC）的变化，分析患者不同利福平血药浓度对患者机体免疫细胞CD4＋T淋巴细胞、CD8＋T淋巴细胞、调节性T细胞、MDSC的影响以及治疗效果。结果利福平治疗后CD4＋T淋巴细胞和CD8＋T淋巴细胞水平显著升高，而MDSC和调节性T细胞（ Treg）细胞水平显著降低，利福平高浓度组的CD4＋T细胞和CD8＋T细胞水平显著高于低浓度组，而MDSC和Treg细胞水平显著低于低浓度组，利福平高浓度组痰转阴率显著高于低浓度组。结论利福平能够改善复治涂阳肺结核患者机体的免疫细水平，修复复治涂阳肺结核患者机体免疫的失调。

The effects of the serum concentration of rifampicin on the immune cells of retreated smear-positive tuberculosis patients

Objective To analyze the effects of serum concentration of rifampicin on the body′s immune cells in the retreated smear-positive tuberculosis patients .Methods Eighty cases with diagnosis of recurrent smear -positive pulmonary tuberculosis patients were included .Treatment regimen was conventional chemotherapy 3HRZE/6HRE.The levels of CD4 +T lymphocytes , CD8 +T lymphocytes , regulatory T cells , and MDSC before treatment and at the end of strengthening phase were compared .The effects of serum concentration on the immune cells and the therapeutic effect were analyzed.Results After treatment, CD4+T cells and CD8 +T lymphocytes were significantly increased , while the MD-SC and Treg cells were significantly reduced .The CD4 +T cells and CD8 +T lymphocytes levels were significantly higher in the group of high rifampicin serum concentration than those in the group of low serum concentration ; and MDSC and Treg cells were also significantly lower .The sputum negative conversion rate was significantly higher in patients with high rifampicin serum concentration .Conclusion Rifampicin can improve the immune ability of retreated smear -positive tu-berculosis patients .