黄芪注射液对肺结核患者趋化因子、肾功能及体液免疫水平的影响
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摘要
目的:探讨黄芪注射液对肺结核患者炎症因子、趋化因子、肾功能及体液免疫水平的影响。方法:收集于我院呼吸内科接受治疗的肺结核患者80例,随机分为对照组与观察组各40例。对照组给予左氧氟沙星治疗;观察组给予黄芪注射液联合左氧氟沙星治疗。分别于治疗前后,比较两组降钙素原(PCT)、干扰素-γ(INF-γ)、单核细胞趋化蛋白-1(MCP-1)、巨噬细胞炎性蛋白1α(MIP-1α)、尿素氮(BUN)、血肌酐(SCr)、尿酸(UA)以及免疫球蛋白(IgA、IgM、IgG)水平。结果:治疗后,两组PCT、INF-γ、MCP-1及MIP-1α水平均明显降低,IgA、IgM、IgG水平明显升高,观察组PCT、INF-γ、MCP-1、MIP-1α水平下降趋势及IgA、IgM、IgG水平上升趋势均明显强于对照组(P<0.05)。治疗后,两组血清中BUN、SCr及UA水平明显升高;观察组BUN、SCr及UA水平上升趋势明显弱于对照组(P<0.05)。结论:黄芪注射液可显著缓解肺结核患者炎症状态,降低趋化因子水平,增强患者肾功能及免疫功能,具有较好的临床疗效。
Objective: To investigate the effects of Astragalus Injection on inflammatory factors, chemokines, renal function and humoral immunity in patients with pulmonary tuberculosis. Methods: 80 patients with pulmonary tuberculosis who were treated in the department of respiratory medicine in our hospital from October 2015 to October 2017 were randomly divided into control group and observation group, 40 cases in each group. Patients in the control group were given levofloxacin treatment; and patients in the observation group were given astragalus injection combined with levofloxacin treatment. Before and after treatment, procalcitonin(PCT), interferon-γ(INF-γ), monocyte chemoattractant protein-1(MCP-1), macrophage inflammatory protein-1α(MIP-1 α), blood urea nitrogen(BUN), serum creatinine(SCr), uric acid(UA) and immunoglobulin(IgA, IgM, IgG) levels were measured and compared between the patients in the two groups. Results: After treatment, the levels of PCT, INF-γ, MCP-1 and MIP-1α in serum of the patients in the two groups were significantly decreased, and the levels of IgA, IgM and IgG were significantly increased. The changes of the PCT, INF-γ, MCP-1, MIP-1α, IgA, IgM and IgG of patients in the observation group were significantly stronger than those in the control group(P<0.05). After treatment, the levels of BUN, SCr and UA in serum of patients in the two groups increased significantly. The serum levels of above indexes of patients in the observation group were significantly lower than those in the control group(P<0.05). Conclusion: Astragalus injection can significantly relieve the inflammatory state of patients with pulmonary tuberculosis, reduce the level of chemokines, enhance the renal function and immune function of patients. It has good clinical efficacy.
Objective: To investigate the effects of Astragalus Injection on inflammatory factors, chemokines, renal function and humoral immunity in patients with pulmonary tuberculosis. Methods: 80 patients with pulmonary tuberculosis who were treated in the department of respiratory medicine in our hospital from October 2015 to October 2017 were randomly divided into control group and observation group, 40 cases in each group. Patients in the control group were given levofloxacin treatment; and patients in the observation group were given astragalus injection combined with levofloxacin treatment. Before and after treatment, procalcitonin(PCT), interferon-γ(INF-γ), monocyte chemoattractant protein-1(MCP-1), macrophage inflammatory protein-1α(MIP-1 α), blood urea nitrogen(BUN), serum creatinine(SCr), uric acid(UA) and immunoglobulin(IgA, IgM, IgG) levels were measured and compared between the patients in the two groups. Results: After treatment, the levels of PCT, INF-γ, MCP-1 and MIP-1α in serum of the patients in the two groups were significantly decreased, and the levels of IgA, IgM and IgG were significantly increased. The changes of the PCT, INF-γ, MCP-1, MIP-1α, IgA, IgM and IgG of patients in the observation group were significantly stronger than those in the control group(P<0.05). After treatment, the levels of BUN, SCr and UA in serum of patients in the two groups increased significantly. The serum levels of above indexes of patients in the observation group were significantly lower than those in the control group(P<0.05). Conclusion: Astragalus injection can significantly relieve the inflammatory state of patients with pulmonary tuberculosis, reduce the level of chemokines, enhance the renal function and immune function of patients. It has good clinical efficacy.
引文
1 Yuan YQ,Lin DZ,Feng L,et al.Upregulation of miR-196b-5p attenuates BCG uptake via targeting SOCS3 and activating STAT3 in macrophages from patients with long-term cigarette smoking-related active pulmonary tuberculosis[J].J Transl Med,2018,16(1):284.
2 Yan LP,Xiao HP,Zhang Q.Using simultaneous amplification and testing method for evaluating the treatment outcome of pulmonary tuberculosis[J].BMC Infect Dis,2018,18(1):512.
3 Castro AZ,Moreira AR,Oliveira J,et al.Clinical impact and cost analysis of the use of either the Xpert MTB Rif test or sputum smear microscopy in the diagnosis of pulmonary tuberculosis in Rio de Janeiro,Brazil[J].Rev Soc Bras Med Trop,2018,51(5):631-637.
4 Buonsenso D,Pezza L,Valentini P.Utility of point-of-care ultrasound in children with pulmonary tuberculosis[J].Pediatr Infect Dis J,2018,37(11):e280-e281.
5 Khumsri J,Hiransuthikul N,Hanvoravongchai P,et al.Effectiveness of tuberculosis screening technology in the initiation of correct diagnosis of pulmonary tuberculosis at a tertiary care hospital in thailand:comparative analysis of xpert MTB/RIF versus sputum AFB smear[J].Asia Pac J Public Health,2018,30(6):542-550.
6 石中全.黄芪注射液对耐药肺结核患者免疫功能的影响[J].辽宁中医杂志,2017,44(3):511-513.
7 周义乾,刘玉林,刘清珍,等.黄芪注射液对肺结核患者T细胞亚群的影响及近期疗效[J].第四军医大学学报,1999,20(10):S57-S59.
8 中华医学会结核病学分会.肺结核诊断和治疗指南[J].中国实用乡村医生杂志,2013,20(2):7-11.
9 Murphy ME,Wills GH,Murthy S,et al.Gender differences in tuberculosis treatment outcomes:a post hoc analysis of the REMoxTB study[J].BMC Med,2018,16(1):189.
10 Tegegne BS,Mengesha MM,Teferra AA,et al.Association between diabetes mellitus and multi-drug-resistant tuberculosis:evidence from a systematic review and meta-analysis[J].Syst Rev,2018,7(1):161.
11 Squeglia F,Ruggiero A,Berisio R.Collagen degradation in tuberculosis pathogenesis:the biochemical consequences of hosting an undesired guest[J].Biochem J,2018,475(19):3123-3140.
12 Y1lmaz FF,Era? R,Ermertcan R,et al.In vitro effects of ciprofloxacin,levofloxacin and moxifloxacin on Mycobacterium tuberculosis isolates[J].Tuberk Toraks,2018,66(1):32-36.
13 Bouton TC,Phillips PPJ,Mitnick CD,et al.An optimized background regimen design to evaluate the contribution of levofloxacin to multidrug-resistant tuberculosis treatment regimens:study protocol for a randomized controlled trial[J].Trials,2017,18(1):563.
14 刘亚玮,毕丽鑫,赵磊.黄芪注射液辅助治疗耐多药肺结核的临床效果及对免疫功能的影响[J].现代医学,2016,44(4):462-466.
15 洪旭华,陈凯.结核药联合利福喷丁对肺结核患者免疫功能、炎症因子、VEGF及MMP-9的影响[J].昆明医科大学学报,2016,37(2):111-114.
16 刘楠,毛辉青.青海地区藏族肺结核患者血清SIL-2R、IFN-γ、HBD-2、MCP-1的表达及意义[J].中华疾病控制杂志,2015,19(6):590-592.
17 张国用.中药黄芪的药理作用及其临床应用研究[J].实用心脑肺血管病杂志,2012,20(6):1059-1060.
18 黄培生,赖晓宇,张东华.黄芪注射液对肺结核患者多种临床指标的影响[J].临床肺科杂志,2015,20(3):435-437.
2 Yan LP,Xiao HP,Zhang Q.Using simultaneous amplification and testing method for evaluating the treatment outcome of pulmonary tuberculosis[J].BMC Infect Dis,2018,18(1):512.
3 Castro AZ,Moreira AR,Oliveira J,et al.Clinical impact and cost analysis of the use of either the Xpert MTB Rif test or sputum smear microscopy in the diagnosis of pulmonary tuberculosis in Rio de Janeiro,Brazil[J].Rev Soc Bras Med Trop,2018,51(5):631-637.
4 Buonsenso D,Pezza L,Valentini P.Utility of point-of-care ultrasound in children with pulmonary tuberculosis[J].Pediatr Infect Dis J,2018,37(11):e280-e281.
5 Khumsri J,Hiransuthikul N,Hanvoravongchai P,et al.Effectiveness of tuberculosis screening technology in the initiation of correct diagnosis of pulmonary tuberculosis at a tertiary care hospital in thailand:comparative analysis of xpert MTB/RIF versus sputum AFB smear[J].Asia Pac J Public Health,2018,30(6):542-550.
6 石中全.黄芪注射液对耐药肺结核患者免疫功能的影响[J].辽宁中医杂志,2017,44(3):511-513.
7 周义乾,刘玉林,刘清珍,等.黄芪注射液对肺结核患者T细胞亚群的影响及近期疗效[J].第四军医大学学报,1999,20(10):S57-S59.
8 中华医学会结核病学分会.肺结核诊断和治疗指南[J].中国实用乡村医生杂志,2013,20(2):7-11.
9 Murphy ME,Wills GH,Murthy S,et al.Gender differences in tuberculosis treatment outcomes:a post hoc analysis of the REMoxTB study[J].BMC Med,2018,16(1):189.
10 Tegegne BS,Mengesha MM,Teferra AA,et al.Association between diabetes mellitus and multi-drug-resistant tuberculosis:evidence from a systematic review and meta-analysis[J].Syst Rev,2018,7(1):161.
11 Squeglia F,Ruggiero A,Berisio R.Collagen degradation in tuberculosis pathogenesis:the biochemical consequences of hosting an undesired guest[J].Biochem J,2018,475(19):3123-3140.
12 Y1lmaz FF,Era? R,Ermertcan R,et al.In vitro effects of ciprofloxacin,levofloxacin and moxifloxacin on Mycobacterium tuberculosis isolates[J].Tuberk Toraks,2018,66(1):32-36.
13 Bouton TC,Phillips PPJ,Mitnick CD,et al.An optimized background regimen design to evaluate the contribution of levofloxacin to multidrug-resistant tuberculosis treatment regimens:study protocol for a randomized controlled trial[J].Trials,2017,18(1):563.
14 刘亚玮,毕丽鑫,赵磊.黄芪注射液辅助治疗耐多药肺结核的临床效果及对免疫功能的影响[J].现代医学,2016,44(4):462-466.
15 洪旭华,陈凯.结核药联合利福喷丁对肺结核患者免疫功能、炎症因子、VEGF及MMP-9的影响[J].昆明医科大学学报,2016,37(2):111-114.
16 刘楠,毛辉青.青海地区藏族肺结核患者血清SIL-2R、IFN-γ、HBD-2、MCP-1的表达及意义[J].中华疾病控制杂志,2015,19(6):590-592.
17 张国用.中药黄芪的药理作用及其临床应用研究[J].实用心脑肺血管病杂志,2012,20(6):1059-1060.
18 黄培生,赖晓宇,张东华.黄芪注射液对肺结核患者多种临床指标的影响[J].临床肺科杂志,2015,20(3):435-437.