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目的:观察泼尼松对结核性胸膜炎患者胸腔积液腺苷脱氢酶(ADA)及细胞因子IL-6和IFN-γ表达水平及疗效的影响。方法:随机将40例结核性胸膜炎患者分为激素治疗组和常规治疗组,两组均接受常规抗结核化学治疗,激素治疗组加用泼尼松30 mg/d,连用7d。分别于治疗前和治疗7、14d采用ELISA法测定患者胸腔积液中IL-6和IFN-γ表达水平,酶比色法测定ADA水平。结果:40例患者经治疗后胸腔积液ADA、IL-6和IFN-γ水平均有不同程度的降低,激素组降低程度均大于常规组(P<0.05)。治疗6个月后,激素组完全有效13例、部分有效5例、无效2例;常规组完全有效10例、部分有效7例、无效3例;激素组疗效好于常规组(P<0.05)。常规组胸膜厚度为(1.43±0.20)mm,粘连7例;激素组胸膜厚度为(1.09±0.13)mm,粘连2例;两组比较,差异有统计学意义(P<0.05)。结论:早期增加激素治疗能有效降低结核性胸膜炎患者IL-6、IFN-γ、ADA水平,治疗效果满意。
Objective: To observe the effect of prednisone on the expression of adenosine dehydrogenase (ADA) and cytokines IL-6 and IFN-γ in patients with tuberculous pleurisy. Methods: 40 patients with tuberculous pleurisy were randomly divided into hormone therapy group and conventional treatment group. Both groups received routine anti-tuberculosis chemotherapy. The hormone therapy group was given prednisone 30 mg / d for 7 days. The levels of IL-6 and IFN-γ in pleural effusion were measured by ELISA before and 7 and 14 days after treatment, respectively. The levels of ADA were measured by enzyme colorimetry. Results: After treatment, the levels of ADA, IL-6 and IFN-γ in pleural effusion decreased to some extent in 40 patients, and the reduction in hormone group was greater than that in routine group (P <0.05). 6 months after treatment, the hormone group was completely effective in 13 cases, partially effective in 5 cases and ineffective in 2 cases. The conventional group was totally effective in 10 cases, partially effective in 7 cases and ineffective in 3 cases. The hormone group was better than the conventional group (P <0.05) . In the conventional group, the pleural thickness was (1.43 ± 0.20) mm, and the adhesion was 7. The pleural thickness was (1.09 ± 0.13) mm in the hormone group and 2 in the adhesion group. The difference was statistically significant (P <0.05). CONCLUSION: Early treatment with hormone can effectively reduce the levels of IL-6, IFN-γ and ADA in patients with tuberculous pleurisy, and the treatment effect is satisfactory.