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目的 提高伴发乙肝初治涂阳肺结核治疗疗效 ,减少副作用产生。方法 采用IL 2联用2SHRZ/ 4H3R3方案治疗 50例伴发乙肝初治涂阳肺结核 ,并以同期用 2SHRZ/ 4H3R3和一般护肝药治疗2 3例作为对照。结果 治疗 6月末IL 2组痰菌阴转率、HBeAg和HBV DNA的转阴率分别为 96.0 %、70 .4 %和 71.4 % ,明显高于对照组的 65.3%、8.3%和 14.3% (P <0 .0 1) ,并且前者肝功损害发生率和停药率均为 0 ,要明显低于后者的 2 6.1% (P <0 .0 1) ,2年随访IL 2组痰菌复发率、HBeAg和HBV DNA的转阴率分为 0、10 .5%和 10 .0 % ,与对照组 6.7%、0和 50 .0 %无明显差别 (P <0 .0 5)。结论 IL 2有较好抗痨、抑制乙肝病毒复制和间接改善肝脏病变 ,降低抗痨药物肝功损害作用 ,值得临床进一步探讨。
Objective To improve the therapeutic effect of initial treatment of smear positive pulmonary tuberculosis in hepatitis B and reduce the side effects. Methods 50 patients with smear-positive pulmonary tuberculosis associated with hepatitis B were treated with IL 2 combined with 2SHRZ / 4H3R3 regimen and 23 cases were treated with 2SHRZ / 4H3R3 and general hepatoprotective drug during the same period. Results The negative rates of sputum negative conversion rate, HBeAg and HBV DNA in IL 2 group were 96.0%, 70.4% and 71.4% respectively at the end of 6th month of treatment, which were significantly higher than 65.3%, 8.3% and 14.3% of the control group <0.01), and the incidence of liver damage and withdrawal rate of the former were both 0, which was significantly lower than the latter (6.11%, P <0.01) The rates of negative conversion of HBeAg and HBV DNA were 0,10. 5% and 10. 0%, which were not significantly different from those of the control group (6.7%, 0 and 50.0%) (P <0. Conclusion IL 2 has better anti-gall bladder, inhibit the replication of hepatitis B virus and indirectly improve the liver lesions and reduce the anti-tang drug liver function damage, it is worth further clinical study.