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目的了解母牛分支杆菌菌苗(微卡)对矽肺结核患者周围血淋巴细胞水平的影响,为矽肺结核患者提供一种免疫辅助治疗方法。方法将矽肺结核病人按年龄、病变期别等条件随机配对分为微卡使用组(治疗组)和不使用组(对照组)。治疗组臀部肌内深部注射微卡22.5μg/次,每2周1次;对照组除不使用微卡外,其他结核化疗方案与治疗组相同。分别于治疗前、微卡使用1、2、4个月时抽血进行周围血T淋巴细胞等各项指标的分析研究。结果与对照组比较,治疗组在微卡使用4个月时CD3、CD4水平明显高于对照组(P<0.05)。治疗组自身前后比较,CD3、CD4平均水平有随使用微卡时间的延长而逐渐增高的趋势(P<0.01或0.05),至4个月时各项细胞免疫指标平均值基本恢复至正常水平。此外,治疗组CD3、CD4、CD8的异常率(%)有随治疗时间的延长而降低的趋势(P<0.05)。治疗组治疗后胸片结核浸润性病变的吸收率明显高于对照组(P<0.05)。结论微卡可以增加矽肺结核患者体内T淋巴细胞水平,可作为矽肺结核患者免疫辅助治疗的参考方法。
Objective To understand the effect of Mycobacterium vaccae vaccine on the level of peripheral blood lymphocytes in patients with silicotic pulmonary tuberculosis and to provide an immune adjuvant therapy for patients with silicotic pulmonary tuberculosis. Methods Patients with silicotic pulmonary tuberculosis were randomized into groups according to the age and the stage of disease. The patients were divided into two groups (treatment group) and non-use group (control group). The intramuscular injection of intramuscular injection of micro-card 22.5μg / time, once every two weeks; the control group except the use of micro-card, the other tuberculosis chemotherapy and treatment group the same. Respectively before treatment, micro-card use 1,2,4 months of blood for peripheral blood T lymphocytes and other indicators of the study. Results Compared with the control group, the CD3 and CD4 levels in the treatment group were significantly higher than those in the control group at 4 months (P <0.05). Before and after treatment, the average level of CD3 and CD4 in the treatment group tended to increase gradually with the extension of the time of using the micro-card (P <0.01 or 0.05). By the end of 4 months, the average value of all the cellular immunity indexes returned to normal levels. In addition, the abnormal rate (%) of CD3, CD4 and CD8 in treatment group decreased with the prolongation of treatment time (P <0.05). After treatment, the absorption rate of tuberculosis infiltrative lesions of the treatment group was significantly higher than that of the control group (P <0.05). Conclusion Micro-card can increase the level of T lymphocytes in patients with silicotic pulmonary tuberculosis and can be used as a reference method for immune adjuvant therapy in patients with silicosis.