纤维支气管镜灌注抗结核药物对耐多药结核病患者炎症因子及肺功能的影响

目的 探讨纤维支气管镜灌注抗结核药物对耐多药结核病患者炎症因子及肺功能的影响.方法 将96例耐多药结核病患者分为介入组和对照组,每组48例.对照组根据药敏试验结果制定个性化化疗方案.介入组在对照组基础上,采用纤维支气管镜灌注治疗.对比两组的痰菌转阴、病灶吸收、空洞闭合情况.于治疗前后,检测两组的炎症因子和肺功能的变化.结果 观察组痰菌转阴率、病灶吸收率、空洞闭合率均显著高于对照组,差异有统计学意义(P＜0.05);两组治疗后C反应蛋白(CRP)、IL-6明显降低,干扰素-γ(IFN-γ)明显升高(P＜0.05);治疗后,观察组的CRP、IL-6明显低于对照组,IFN-γ显著高于对照组,差异有统计学意义(P＜0.05);两组治疗后的FEV1、FEV1/FVC、每分钟最大通气量(MVV)明显升高(P＜0.05);治疗后,观察组FEV1、FEV1/FVC、MVV显著高于对照组,差异有统计学意义(P＜0.05);两组的不良反应发生率比较,差异无统计学意义(P＞0.05).结论 纤维支气管镜灌注抗结核药物能显著减轻耐多药结核病患者的炎症反应,改善肺功能.

Effect of anti-tuberculosis drugs on the inflammatory factors and pulmonary function in patients with multi drug resistant tuberculosis

Objective To investigate the effect of fiberoptic bronchoscopy on the inflammatory factors and pulmonary function in patients with multidrug-resistant tuberculosis.Methods 96 cases of multidrug-resistant tuberculosis patients were divided into intervention group and control group,each group of 48 cases.The control group according to the results of drug sensitivity test to develop personalized chemotherapy program.On the basis of the control group,the intervention group was treated with fiberoptic bronchoscopy.Two groups of sputum negative,focus absorption,cavity closure were compared.Before and after treatment,the changes of inflammatory factors and pulmonary function in the two groups were detected.Results In the observation group,the sputum negative rate,the absorption rate and the cavity closure rate were significantly higher than those in the control group.The difference was statistically significant (P ＜ 0.05).After treatment,the C-reactive protein (CRP) and interleukin 6 (IL-6) of the two groups were significantly decreased,and interferon-) (IFN-γ) was significantly higher (P ＜0.05).After treatment,the CRP and IL-6 in the observation group were significantly lower than those in the control group,and the IFN-γ was significantly higher than that in the control group.The difference was statistically significant (P ＜ 0.05).FEV1,FEV1/FVC and MVV were significantly increased after treatment in the two groups (P ＜ 0.05).After treatment,the FEV1,FEV1/FVC and MVV in the observation group were significantly higher than those in the control group.The difference was statistically significant (P ＜0.05).Adverse reactions between the two groups showed no significant difference (P ＞0.05).Conclusions The perfusion of anti tuberculosis drugs can significantly reduce the inflammatory response and improve pulmonary function in patients with multidrug resistant.