乌体林斯联合正规抗结核治疗初治菌阳肺结核的疗效及对免疫功能的影响

目的探讨乌体林斯联合正规抗结核治疗初治菌阳肺结核的疗效及其对免疫功能的影响。方法将108例初治菌阳肺结核患者随机分为两组,每组各54例。对照组采用2HRZE/4HR（H：异烟肼,Z：吡嗪酰胺,E：乙胺丁醇,R：利福平）标准化疗方案正规治疗,治疗组在此基础上加用乌体林斯,疗程均为2个月。观察两组患者的临床疗效、痰菌转阴情况及免疫功能指标的变化。结果治疗组的总有效率和痰菌转阴率为88.9%和83.3%,显著高于对照组74.1%和64.8%（χ2=3.93、4.82,均P〈0.05）;两组CD3＋、CD4＋、CD8＋及CD4＋/CD8＋均有所改善,但与对照组比较,治疗组CD3＋、CD4＋、CD4＋/CD8＋明显升高,CD8＋明显降低（t=5.07、4.68、5.56、5.43,均P〈0.05）;治疗组干扰素-γ显著上升,血清白介素-10水平显著下降（t=25.46、19.63,均P〈0.05）。结论在正规抗结核的基础上联合乌体林斯治疗初治菌阳肺结核安全有效,初治菌阳阴转率高,病灶吸收快,可提高患者机体免疫水平。

Efficacy and its influence on Mycobacterium Phlei F.U.36 combined with regular anti-antituberculosis treatment for new smear positive pulmonary tuberculosis

Objective To explore clinical effectiveness and its influence on Mycobacterium Phlei F.U.36 combined with regular anti-antituberculosis treatment for new smear positive pulmonary tuberculosis. Methods 108 cases with new smear positive pulmonary tuberculosis were randomly divided into two groups, with 54 cases in each group. Con- trol group was treated with regular anti-antituberculosis treatment of 2HRZE/4HR （H： Isoniazid, Z： Pyrazinamide, Z： Ethambutol, R： Rifampicin）, and treatment group was given Mycobacterium Phlei F.U.36 additionally. All the treat- ment courses were 2 months. The total clinical effect, sputum negative conversion and indicators of immune function were compared. Results The total effective rate and sputum negative conversion rate after treatment in treatment group were 88.9% and 83.3%, which were significantly higher than 74.1% and 64.8% in control group （x2=3.93, 4.82, all P 〈 0.05）. After treatment for 2 months, the CD3＋, CD4＋, CD8＋ and CD4＋/CD8＋ in both groups were improved, but compared with control group, the CD3＋, CD4＋ and CD4YCD8＋ in treatment group were significantly increased, and CD8＋ was reduced （t = 5.07, 4.68, 5.56, 5.43, all P 〈 0.05）. The level of IFN-γincreased, IL-10 decreased more remarkably than those in control group （t = 25.46, 19.63, all P 〈 0.05）. Conclusion It is effective and safe of combina- tion use of Mycobacterium Phlei F.U.36 and regular anti-antituberculosis treatment for new smear positive pulmonary tuberculosis, it has high sputum negative conversion rate and focus absorption, can contribute to improve organism im- munity level.