糖皮质激素治疗结核性胸膜炎的疗效及对炎症细胞因子的影响

胡全君

[摘要] 目的 研究糖皮质激素治疗结核性胸膜炎的临床疗效及对炎症细胞因子水平的影响。方法 回顾性分析该院2014年1月—2016年8月收治的86例结核性胸膜炎患者临床资料，根据治疗方法不同进行分组，将常规治疗的40例患者纳入对照组，常规治疗+糖皮激素治疗的46例纳入观察组，对比两组患者胸腔积液吸收时间、全身症状缓解时间、住院时间、IL-6、IL-8含量，并统计治疗总有效率。结果 观察组胸腔积液吸收时间、全身症状缓解时间、住院时间分别为（18.54±3.89）、（6.92±2.34）、（23.91±3.73）d ，均较对照组显著缩短（P<0.05）；观察组治疗后的IL-6和IL-8分别为（73.24±15.32）、（167.43±152.54）pg/mL，较对照组显著下降（P<0.05）；观察组治疗总有效率为97.83%，与对照组的72.50%比较显著提高（P<0.05）。结论 糖皮激素治疗结核性胸膜炎疗效确切，可显著缩短患者症状缓解时间和住院时间，抑制胸腔局部免疫细胞，提高临床疗效，值得推广。

[关键词] 结核性胸膜炎；炎症细胞因子；糖皮激素；疗效

[中图分类号] R5 [文献标识码] A [文章编号] 1674-0742（2017）05（c）-0012-03

[Abstract] Objective To research the curative effect of glucocorticoid in treatment of tuberculous pleuritic and effect on the inflammatory cell factors. Methods 86 cases of patients with tuberculous pleuritic admitted and treated in our hospital from January 2014 to August 2016 were selected and divided into two groups according to different treatment methods， the control group with 40 cases adopted the routine treatment， while the observation group with 46 cases adopted the routine treatment and glucocorticoid， and the pleural effusion absorption time， relief time of general symptoms， length of stay， contents of IL-6 and IL-8 were compared between the two groups， and the total treatment effective rate was counted. Results The pleural effusion absorption time， relief time of general symptoms， length of stay in the observation group were respectively （18.54±3.89），（6.92±2.34），（23.91±3.73）d， which were obviously shortened compared with those in the control group（P<0.05）， after treatment， the IL-6 and IL-8 in the observation group were respectively （73.24±15.32） and （167.43±152.54）pg/mL， which were obviously decreased compared with those in the control group（P<0.05）， and the total treatment effective rate in the observation group was obviously increased compared with that in the control group（97.83% vs 72.50%）（P<0.05）. Conclusion The curative effect of glucocorticoid in treatment of tuberculous pleuritic is definite， which can obviously shorten the relief time of symptoms and length of stay， suppress the local chest immune cell and improve the clinical curative effect， and it is worth promotion.

[Key words] Tuberculous pleuritic； Inflammatory cell factor； Glucocorticoid； Curative effect

结核性胸膜炎为呼吸内科常见疾病，为结核病的第4类型，其主为结核杆菌及其自溶产物、代谢产物进入超敏感机体的胸膜炎儿引起的炎症反应，如果不给于及时有效的治疗措施，病情往往会进展为胸膜肥厚粘连、包裹性积液，导致肺功能受损[1-2]。当前关于该病的发病机制还尚未明确，但有研究显示炎症细胞因子在其发病中发挥着重要影响[3]。该研究回顾性分析该院2014年1月—2016年8月收治的86例结核性胸膜炎患者资料，探讨胸腔局部注射糖皮激素对患者炎症细胞因子IL-6、IL-8的影響及临床疗效，旨在为结核性胸膜炎的治疗提供参考，现报道如下。

1 资料与方法

1.1 一般资料

方便选取的86例结核性胸膜炎患者入院时均确诊，符合结核性胸膜炎的诊断标准[4]，胸腔积液>500 mL，发病后未接受过抗结核相关治疗，排除严重脏器功能障碍、免疫性系统疾病，精神疾病患者，哺乳及妊娠期妇女。……