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目的 :探究支气管镜局部注射联合免疫治疗对耐药肺结核的临床疗效及机体免疫改善作用。方法 :2012年10月~2014年10月收治的86例肺结核患者,根据个人意愿,经济状况,身体条件平均分为观察组及对照组,每组43例。比较两组患者痰菌转阴率、临床症状改善情况、炎症因子水平、细胞免疫以及体液免疫水平。结果:治疗后,观察组患者的痰菌转阴率为89.5%,显著高于对照组的65.63%;两组患者的临床症状均得到有效缓解,观察组患者的临床症状改善情况显著优于对照组;两组患者的CRP、IL-4水平显著降低,且观察组显著低于对照组;两组患者IFN-γ水平均明显增加,观察组显著高于对照组;观察组患者T淋巴细胞群CD4+、CD4+/CD8+水平显著升高,CD8+水平显著下降,对照组与治疗前相比无显著改善;观察组患者Ig A、Ig G均有轻微上升,但与治疗前相比无统计学差异;对照组患者Ig A、Ig G水平也无显著改善。结论 :与常规多药物联合方案相比,支气管镜下注射联合免疫治疗可显著提高耐药肺结核患者的临床疗效,积极改善患者机体免疫机能,增强抗结核能力,值得临床推广。
Objective: To investigate the clinical efficacy of bronchoscope local injection combined with immunotherapy on drug-resistant pulmonary tuberculosis and improve immune function. Methods: From October 2012 to October 2014, 86 patients with tuberculosis were divided into observation group and control group according to their wishes, economic status and physical condition, with 43 cases in each group. The sputum negative rate, clinical symptom improvement, inflammatory factor level, cellular immunity and humoral immunity were compared between the two groups. Results: After treatment, the sputum negative rate of the observation group was 89.5%, which was significantly higher than that of the control group (65.63%). The clinical symptoms of both groups were effectively relieved, and the improvement of clinical symptoms in the observation group was significantly better than that of the control group Group. The levels of CRP and IL-4 in the two groups were significantly decreased, and the observation group was significantly lower than the control group; IFN-γ levels were significantly increased in both groups, the observation group was significantly higher than the control group; T lymphocyte population CD4 +, CD4 + / CD8 + and CD8 + in control group were significantly lower than those in control group. Ig A and Ig G in patients in observation group increased slightly, but there was no significant difference between before and after treatment. The control group patients Ig A, Ig G levels did not significantly improve. Conclusion: Compared with the conventional multi-drug combination regimen, bronchoscopy combined with immunotherapy can significantly improve the clinical efficacy of drug-resistant pulmonary tuberculosis patients, and actively improve the patient’s immune function and enhance anti-TB capacity, worthy of clinical promotion.