白介素-2联用短化治疗50例伴发乙肝初治涂阳肺结核疗效观察

目的　提高伴发乙肝初治涂阳肺结核治疗疗效,减少副作用产生。方法 采用IL2联用2SHRZ/4H₃R₃方案治疗50例伴发乙肝初治涂阳肺结核,并以同期用2SHRZ/4H₃R₃和一般护肝药治疗23例作为对照。结果 治疗6月末IL-2组痰菌阴转率、HBeAg和HBVDNA的转阴率分别为96.0%、70.4%和71.4%,明显高于对照组的65.3%、8.3%和14.3%(P<0.01),并且前者肝功损害发生率和停药率均为0,要明显低于后者的26.1%(P<0.01),2年随访IL2组痰菌复发率、HBeAg和HBVDNA的转阴率分为0、10.5%和10.0%,与对照组6.7%、0和50.0%无明显差别(P<0.05)。结论 IL-2有较好抗痨、抑制乙肝病毒复制和间接改善肝脏病变,降低抗痨药物肝功损害作用,值得临床进一步探讨。

The observation of curative effect of IL-2 supplemented with short-course chemotherapy for 50 cases of smear-positive pulmonary tuberculosls accompanying hepatitis B

Objective To improve the curative effect and reduce side effect in the treatment of smear-positive pulmonary tuberculosis accompanying hepatitis B.Methods Use Interleukin-2(IL-2) in a daily dose of 20000 U supplemented with 2SHRZ/4H₃R₃ for 50 patients and contrast with 23 patients treated by 2SHRZ/4H₃R₃ and ordinary liver-curing medicine.Results The sputum negative conversion rates,HBeAg and HBV-DNA from positive to negative of the active group after 6 months themotherapy were 96.0%,70.4% and 71.4% respectively,which is obviously higher than 65.3%,8.3%and 14.3% of the control group (P<0.01).In the meantime,both the hepatic damage rate and drug withdrawal rate of the former were 0,Which is also obviously lower than the latter 26.1%(P<0.01),the recurrence rate of sputum,the conversion rates of HBeAg and HBV-DNA from positive to negative of the active group were 0,10.5% and 10.0% and the rates of control group were 6.7%,0,50.5% respectively according to a two-year follow-up examination,which indicatng less difference between active and control groups.Conclusion IL-2 is effective in antituberculosis,inhibit of reproduction of hepatitis B virus,as well as in reliving liver pathological process and reducing hepatic damage by antituberculous drugs.