摘要
目的研究血清可溶性髓系细胞触发受体-1(sTREM-1)、可溶性T细胞免疫球蛋白黏蛋白3(sTim-3)、泛素连接酶4A(cullin4A)在反映4MRZE化疗方案的疗效及肺结核患者肺部受累情况中的价值。方法将2018年1月至2021年1月武汉市金银潭医院及赤壁市人民医院收治的265例肺结核患者根据治疗方案的不同分为采用2H3R3Z3E3/4H3R3标准四联疗法方案治疗的对照组(n=97)、4MRZE超短程化疗方案治疗的4MRZE组(n=88)和2HRZE/4HR方案治疗的2HRZE/4HR组(n=80)。比较3组治疗后临床疗效,以及治疗前和治疗2、4个月血清sTREM-1、sTim3、cullin4A水平变化,分析血清sTREM-1、sTim3、cullin4A在反映肺结核患者肺部受累情况中的价值。结果4MRZE组、2HRZE/4HR组治疗2、4个月时的痰菌转阴率及病灶有效吸收率均高于对照组(P<0.05),且4MRZE组高于2HRZE/4HR组(P<0.05);在治疗过程中,3组患者血清sTREM-1、sTim3呈下降趋势,而cullin4A mRNA呈上升趋势,且4MRZE组患者治疗2、4个月的血清sTREM-1、sTim3显著低于2HRZE/4HR组、对照组(P<0.05),而cullin4A mRNA显著高于2HRZE/4HR组、对照组(P<0.05)。但是治疗完成后,3组痰菌转阴率、病灶有效吸收率,以及血清sTREM-1、sTim3水平比较,差异无统计学意义(P>0.05)。结论4MRZE化疗方案在肺结核治疗中具备治疗周期短的同时保证治疗效果良好的优点。血清sTREM-1、sTim3、cullin4A水平在反映痰菌转阴及病灶有效吸收中具有一定价值。
Objective To investigate the value of serum soluble triggering receptor expressed on myeloid cell-1(sTREM-1),soluble T cell immunoglobulin mucin 3(sTim-3)and ubiquitin ligase 4A(cullin4A)in reflecting the efficacy of 4MRZE chemotherapy and pulmonary involvement in patients with pulmonary tuberculosis.Methods From January 2018 to January 2021,265 patients with tuberculosis were admitted to Wuhan Jinyintan Hospital and Chibi People′s Hospital were included.According to the different treatment regimen,the patients were divided into three groups,the control group(n=97)treated with 2H3R3Z3E3/4H3R3 standard quadruple therapy regimen,the 4MRZE group(n=88)treated with 4MRZE ultra-short-course chemotherapy regimen and the 2HRZEf/4HR group treated with 2HRZE/4HR regimen(n=80).The clinical efficacy of the three groups after treatment was compared,as well as the changes of serum sTREM-1,sTim3 and cullin4A levels before treatment and 2 and 4 months after treatment.Meanwhile,the value of serum sTREM-1,sTim3 and cullin4A in reflecting pulmonary involvement in patients with pulmonary tuberculosis was analyzed.Results The sputum negativeconversion rate and the effective absorption rate of lesions in 4MRZE group and 2HRZE/4HR group were significantly higher than those in control group at 2 and 4 months of treatment(P<0.05),and the rates in the 4MRZE group were significantly higher than those in 2HRZE/4HR group(P<0.05).During treatment,serum sTREM-1 and sTim3 in the three groups showed a decreasing trend,while cullin4A mRNA showed an increasing trend,and serum sTREM-1 and sTim3 in 4MRZE group after 2 and 4 months of treatment were significantly lower than those in 2HRZE/4HR group and control group(P<0.05).At the same time,cullin4A mRNA was significantly higher than that in 2HRZE/4HR group and control group(P<0.05).However,after the completion of treatment,there was no significant difference in the sputum negativeconversion rate and the effective absorption rate of lesions,and serum sTREM-1 and sTim3 levels among the three groups(P>0.05).Conclusion 4MRZE chemotherapy regimen has the advantages of short treatment cycle and good therapeutic effect in the treatment of pulmonary tuberculosis.The serum sTREM-1,sTim3 and cullin4A levels have a certain value in reflecting sputum conversion and effective absorption of lesions.
作者
唐莹
唐钊
TANG Ying;TANG Zhao(Department of Clinical Laboratory,Wuhan Jinyintan Hospital,Wuhan,Hubei 430000,China;Department of Infectious Disease,Chibi People′s Hospital,Chibi,Hubei 437300,China)
出处
《国际检验医学杂志》
CAS
2023年第9期1130-1134,共5页
International Journal of Laboratory Medicine
