Objective To observe the efficacy of thymopentin combined with conventional anti-tuberculosis drugs in the treatment of drug resistant tuberculosis(MDR-BT)patients.Methods We retrospectively analyzed the clinical data of 156 MDR-BT patients admitted to the Department of Respiratory Medicine, Wuhan Medical Treatment Center, from January 2014 to January 2016.According to the different clinical treatment programs,patients were divided into control group(67 ca-ses)and observation group(89 cases).Lung function, sputum negative rate, rate of improvement of lesion, immune func-tion,inflammatory factor and adverse reactions in the two groups were observed and compared.Results The FEV1%predic-ted and FEV1/FVC were significantly higher in the observation group than in the control group after 8 weeks of treatment [(80.53 ±3.17)vs.(71.24 ±3.55),t=6.123,P=0.023;(89.78 ±4.26)vs.(81.34 ±4.84),t=6.456,P=0.017]. The rate of conversion of sputum and the rate of improvement of lesion in the observation group were higher than those in the control group(88.76%vs.70.15%,χ2=5.467,P=0.014,93.26% vs.77.61%,χ2=6.112,P=0.003).The levels of CD3 +,CD4 +,CD4 +/CD8 +in T lymphocytes were significantly higher in the observation group than those in the control group before and after treatment[(71.56 ±6.07)vs.(60.11 ±5.32),t=4.998,P=0.032;(39.16 ±5.13)vs.(26.92 ± 3.79),t=5.470,P=0.021;(39.16 ±5.13)vs.(26.92 ±3.79),t=5.470,P=0.021].The level of IL-10 in the observa-tion group was significantly lower than that in control group[(0.40 ±0.09)pg/ml vs.(0.58 ±0.08)pg/ml,t=5.323,P=0.009],while the level of IFNγwas significantly higher than that in control group[(7.44 ±0.32)pg/ml vs.(6.24 ±0.37) pg/ml,t=4.011,P=0.021].The incidence of adverse reactions in the control group was 11.94%.The incidence of adverse reactions in the observation group was 5.62%,the difference was statistically significant(χ2=6.112,P=0.017).Conclu-sion Thymopentin can improve lung function in patients with MDR-BT,improve immune function,promote the absorption of lesions,with high safety.%目的 观察胸腺五肽联合常规抗结核药物治疗耐药性结核病(MDR-TB)患者的疗效及其对免疫功能和血清炎性因子的影响.方法 回顾性分析2014年1月—2016年1月武汉市医疗救治中心呼吸内科收治的MDR-TB患者156例的临床资料.按照临床治疗方案的不同分为对照组(67例)与观察组(89例).对照组采用IHRZE/4HR标准化疗方案,观察组在此基础上联合胸腺五肽注射液,治疗8周后对比2组患者肺功能、免疫功能、炎性因子水平、痰菌转阴率、病灶吸收好转率及不良反应.结果 治疗8周后,观察组FEV1%预计值及FEV1/FVC均明显高于对照组(t=6.123、6.456,P=0.023、0.017);T淋巴细胞CD3+、CD4+、CD4+/CD8+水平均显著高于治疗前和对照组(P均<0.05),炎性因子IL-10水平显著低于对照组,而IFN-γ水平显著高于对照组(P均<0.05).痰菌转阴率、病灶吸收好转率较对照组均升高(88.76%vs.70.15%,χ2=5.467,P=0.014;93.26% vs.77.61%,χ2=6.112,P=0.003);不良反应发生率观察组为5.62%,对照组为11.94%,2组比较差异有统计学意义(χ2=6.112,P=0.017).结论 胸腺五肽可以提高MDR-TB患者治疗效果,提高免疫功能,促进病灶吸收,具有较高的安全性.
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