卡介菌多糖核酸辅助治疗结核性胸腔积液时胸液中sIL-2R水平表达的意义

目的　评价卡介菌多糖核酸(斯奇康)(BCG-PSN)作为免疫调节剂辅助治疗结核性胸腔积液的有效性和安全性。评价其对结核性胸腔积液中可溶性白细胞介素-2受体(SIL-2R)的调节作用。方法 将38例初治结核性胸腔积液患者随机分为2组,治疗组22例,对照组16例。治疗组给予抽胸液+胸腔内注射BCG-PSN+联合化疗;对照组给予抽胸液+联合化疗,观察治疗前、后胸液中sIL-2R浓度变化,观察胸液吸收速度,分析卡介菌多糖核酸疗效及不良反应。结果 治疗前2组胸液sIL-2R浓度比较无显著性差异(P＞0.05),治疗后治疗组胸液sIL-2R浓度明显下降,治疗30d后胸液sIL-2R浓度为1004±109ku/L,与同组治疗前1219±121ku/L比较有显著性差异(P＜0.05),对照组治疗后40d胸液sIL-2R浓度开始下降。治疗组治疗后40d胸液吸收率95.5%,对照组68.7%,比较P＜0.05。结论 卡介菌多糖核酸能抑制结核性胸腔积液患者胸液中sIL-2R过度分泌,通过增强机体细胞免疫功能,胸腔内注射可以加速结核性胸膜炎胸液吸收作用。临床观察斯奇康无不良反应。

A study on treatment effects of effusion levels of sIL-2R in tuberculous pleural effusion patients by using polysaccharide-nucleic acid of BCG

objective To observe the treatment effects of polysaccharide-nucleic acid of BCG (BCG-PSN) as immune regulation preparation in patients with tuberculous pleural effusion. MethodThirty-eight tuberculous pleural effusion patients were divided into trial group and control group randomly. All patients were treated by pleurocentesis and the same chemotherapy regime, but the trial group was treated by pleurae cavum injection BCG-PSN. Before and after treatment, the effusion levels of sIL-2R were measured. ResultThe effusion levels of sIL-2R in two groups have no significant difference (P<0.05) before treatment. After treatment 30 days, the effusion levels of sIL-2R in trial group decrease significantly (P<0.05). At the end of the course, the fluid absorbed rates of the trial group and the control group were 95.5% and 68.7% respectively. The information above was significant in statistics (P<0.05). ConclusionBCG-PSN can inhibit the extreme secretion of sIL-2R in tuberculous pleural fluid. By injection BCG-PSN in pleurae cavum, it can improve the fluid absorbed rate. There was no side effect observed during applying BCG-PSN in pleurae carum.