[1]吴 霞.小剂量糖皮质激素在重症结核患者中的应用[J].医学信息,2021,34(23):84-86.[doi:10.3969/j.issn.1006-1959.2021.23.023]
　WU Xia.Application of Low-dose Glucocorticoid in Patients with Severe Tuberculosis[J].Medical Information,2021,34(23):84-86.[doi:10.3969/j.issn.1006-1959.2021.23.023]
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小剂量糖皮质激素在重症结核患者中的应用()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
34卷
期数:
2021年23期
页码:
84-86
栏目:
论著
出版日期:
2021-12-01

文章信息/Info

Title:
Application of Low-dose Glucocorticoid in Patients with Severe Tuberculosis
文章编号:
1006-1959（2021）23-0084-03
作者:
吴 霞
（如皋市人民医院感染性疾病科，江苏 如皋 226500）
Author(s):
WU Xia
(Department of Infectious Diseases,Rugao People’s Hospital,Rugao 226500,Jiangsu,China)
关键词:
小剂量糖皮质激素; 重症结核; 血清炎性因子; 细胞免疫学指标; 肺部病灶吸收率
Keywords:
Low dose glucocorticoid; Severe tuberculosis; Serum inflammatory factors; Cellular immunological indexes; Absorption rate of pulmonary lesions
分类号:
R459.1；R521
DOI:
10.3969/j.issn.1006-1959.2021.23.023
文献标志码:
A
摘要:
目的 观察小剂量糖皮质激素在重症结核患者中的应用效果。方法 选取2018年6月-2021年6月在我治疗的重症肺结核患者60例作为研究对象，将2018年6月-2019年12月入院患者30例设为对照组，2020年1月-2021年6月入院患者30例设为研究组。对照组采用标准四联抗结疗法治疗，研究组在此基础上加以小剂量泼尼松治疗。治疗4周后比较两组病灶吸收率、痰菌转阴率、体温变化，治疗前后两组血清炎性因子水平和细胞免疫指标水平。结果 研究组病灶吸收率、痰菌转阴率分别为93.33%、90.00%，高于对照组的73.33%、66.67%（P＜0.05）；研究组体温低于对照组（P＜0.05）；治疗后，两组血清炎性因子中，C反应蛋白水平、肿瘤坏死因子、白介素-6水平均低于干预前，且研究组低于对照组（P＜0.05）；两组淋巴细胞总数、CD3+、CD4+、CD4+/CD8+水平均高于治疗前，且研究组高于对照组（P＜0.05）。结论 小剂量泼尼松治疗重症肺结核可提高肺部病灶吸收率与痰菌转阴率，促使体温恢复正常水平，同时降调节血清炎性因子水平，提升细胞免疫指标水平，值得临床借鉴。
Abstract:
Objective To observe the effect of low dose glucocorticoid in patients with severe tuberculosis.Methods Totally 60 patients with severe pulmonary tuberculosis who were treated in our hospital from June 2018 to June 2021 were selected as the study subjects, 30 patients admitted from June 2018 to December 2019 were set as the control group, and 30 patients admitted from January 2020 to June 2021 were set as the study group. The control group was treated with standard quadruple anti-junction therapy, and the study group was treated with low-dose prednisone on this basis. After 4 weeks of treatment, the lesion absorption rate, sputum negative conversion rate and body temperature changes were compared between the two groups. The levels of serum inflammatory factors and cellular immune indexes were compared between the two groups before and after treatment.Results The lesion absorption rate and sputum negative conversion rate in the study group were 93.33% and 90.00%, respectively, which were higher than 73.33% and 66.67% in the control group (P<0.05). The body temperature of the study group was lower than that of the control group (P<0.05). After treatment, the levels of C-reactive protein, tumor necrosis factor and interleukin-6 in serum inflammatory factors in the two groups were lower than those before intervention, and those in the study group were lower than those in the control group (P<0.05). The levels of total lymphocyte count, CD3+, CD4+ and CD4+/CD8+ in the two groups were higher than those before treatment, and those in the study group were higher than those in the control group (P<0.05).Conclusion Low-dose prednisone in the treatment of severe pulmonary tuberculosis can improve the absorption rate of pulmonary lesions and the negative conversion rate of sputum bacteria, promote the recovery of body temperature, reduce and regulate the level of serum inflammatory factors, and improve the level of cellular immune indexes, which is worthy of clinical reference.

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更新日期/Last Update: 1900-01-01