摘要
目的探究利奈唑胺对肺结核并重症肺炎患者T细胞亚群水平、血常规、血清IL-1β、IL-8和TNF-α水平的影响。方法选取2018年7月—2020年7月本院收治的92例PT合并重症肺炎患者作为研究对象,按照随机数表法分为对照组和研究组两组,每组各46例。两组患者均采取抗结核治疗,在此基础上对照组给予静脉滴注万古霉素,研究组给予静脉滴注利奈唑胺,观察两组患者4周后T细胞亚群水平、血常规、血清IL-1β、IL-8和TNF-α水平的差异。结果广义估计方程分析结果显示:组间方面,重复测量结果显示,Waldχ^(2)=11.649,P=0.001,组间差异具有统计学意义(P<0.05),OR=2.563,95%置信区间为(1.090,4.034),提示研究组患者治疗有效率显著高于对照组;时点方面,Waldχ^(2)=42.261,P<0.001,时间差异具有统计意义(P<0.05),提示不同时点下患者治疗有效率差异显著;研究组患者治疗后WBC、PLT、NE明显低于对照组(P<0.05);重复测量结果显示:两组患者CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)、IL-1β、IL-8、TNF-α的时点、CD4^(+)、CD8^(+)、IL-1β、TNF-α的组间、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)、IL-1β、TNF-α的时点与组别的交互效应差异有统计学意义(P<0.05)。治疗前,两组CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)、IL-1β、IL-8、TNF-α比较差异无统计学意义(P>0.05);治疗后研究组CD8^(+)、IL-1β、IL-8、TNF-α显著低于对照组,CD4^(+)、CD4^(+)/CD8^(+)显著高于对照组(P<0.05),且两组患者CD8^(+)、IL-1β、IL-8、TNF-α均低于治疗前,CD4^(+)、CD4^(+)/CD8^(+)高于治疗前(P<0.05)。结论利奈唑胺治疗肺结核并重症肺炎效果显著,能有效改善患者T细胞亚群水平与血常规,降低机体血清IL-1β、IL-8和TNF-α水平。
Objective To explore the influence of linezolid therapy on T-cell subsets,blood routine,serum IL-1,IL-8,and TNF-αlevels in patients with tuberculosis complicated severe pneumonia.Methods From July 2018 to July 2020,92 patients with PT complicated with severe pneumonia admitted to our hospital were selected.According to the random number table method,the patients were randomly divided into control group(46 cases)and study group(46 cases).On the basis of anti-tuberculosis treatment,the control group was intravenously administratedwith vancomycin,and the study group was given intravenous linezolid.The differences of T cell subgroup level,blood routine,serum IL-1,IL-8 and TNF-αbetween the two groupsafter 4 weeks were observed.Results Generalized estimating equation analysis showed that,in terms of the inter-group,the repeated measurement results showed that Waldχ^(2)=11.649,P=0.001,and the difference was statistically significant(P<0.05),OR=2.563,95%confidence interval was(1.090,4.034),suggesting that the effective rate of treatment in the study group was significantly higher than that in the control group.In terms of time points,Waldχ^(2)=42.261,P<0.001,and the difference in time was statistically significant(P<0.05),suggesting significant difference in the effective rate of treatment at different time points.After treatment,WBC,PLT and NE in the study group were significantly lower than those in the control group(P<0.05).Repeated measurements showed that the difference in CD4^(+),CD8^(+),CD4^(+)/CD8^(+),IL-1,IL-8 and TNF-αin time points,inter-group,and interaction between time points and inter-group between the two groups were statistically significant(P<0.05).Before treatment,there were no statistically significant differences in CD4^(+),CD8^(+),CD4^(+)/CD8^(+),IL-1,IL-8,TNF-αbetween the two groups(P>0.05).After treatment,CD8^(+),IL-1,IL-8,TNF-in the study group were significantly lower than those in the control group,and on the contrary the CD4^(+),CD4^(+)/CD8^(+)were significantly higher than those in the control group(P<0.05),moreover,CD8^(+),IL-1,IL-8,TNF-were all lower in both groups than before treatment,and CD4^(+),CD4^(+)/CD8^(+)were higher than before treatment(P<0.05).Conclusions Linezolid is effective in the treatment of pulmonary tuberculosis with severe pneumonia.It could effectively improve T cell subsets and blood routine,and reduce serum IL-1,IL-8 and TNF-αlevels.
作者
高远
贾睿岐
高景利
李振云
崔俊伟
GAO Yuan(The first ward of department of tuberculosis,the first affiliated hospital of Xinxiang Medical College,Xinxiang,Henan,453000,China)
出处
《齐齐哈尔医学院学报》
2021年第8期648-652,共5页
Journal of Qiqihar Medical University
