摘要
目的:探讨胸腔微创置管辅助尿激酶联合地塞米松对结核性胸膜炎患者血清T淋巴细胞相关细胞因子、纤溶活性的影响。方法:选取2019年4月至2023年4月该院收治的结核性胸膜炎患者90例,采用随机数字表法分为地塞米松组、联合组,各45例。地塞米松组患者使用胸腔微创置管辅助地塞米松治疗,联合组患者使用胸腔微创置管辅助尿激酶联合地塞米松治疗。对比两组患者临床症状改善情况、胸膜厚度;检测两组患者肺功能指标[最大呼气流量(MEF)、用力肺活量(FVC)和第1秒用力呼气容积(FEV_(1))]、超敏C反应蛋白(hs-CRP)和肿瘤坏死因子(TNF-α),T淋巴细胞CD4^(+)、CD3^(+),组织型纤溶酶原活化剂(t-PA)/纤溶酶原激活物抑制剂1(PAI-1)、Ⅲ型前胶原(PC-Ⅲ)水平;对比两组患者的治疗效果。结果:联合组患者胸闷消失时间、胸腔积液消失时间和退热时间短于地塞米松组,胸膜厚度低于地塞米松组,差异均有统计学意义(P<0.05)。治疗后,联合组患者MEF、FVC和FEV_(1)水平高于地塞米松组,hs-CRP、TNF-α和PC-Ⅲ水平均低于地塞米松组,CD4^(+)、CD3^(+)和t-PA/PAI-1水平高于地塞米松组,差异均有统计学意义(P<0.05)。联合组患者的总有效率为95.56%(43/45),高于地塞米松组的80.00%(36/45),差异有统计学意义(P<0.05)。结论:使用胸腔微创置管辅助尿激酶联合地塞米松对结核性胸膜炎患者进行治疗,能够有效减轻患者临床症状,改善肺功能,减轻炎症反应,提高免疫功能,改善纤溶活性,治疗效果显著。
OBJECTIVE:To probe into the effects of minimally invasive thoracic catheterization assisted with urokinase combined with dexamethasone on serum T lymphocyte related cytokines and fibrinolytic activity in patients with tuberculous pleurisy.METHODS:A total of 90 patients with tuberculous pleurisy admitted into the hospital from Apr.2019 to Apr.2023 were extracted to be divided into the dexamethasone group and combined group via the random number table method,with 45 cases in each group.Patients in the dexamethasone group were treated with minimally invasive thoracic catheterization assisted with dexamethasone,while the combined group received minimally invasive thoracic catheterization assisted with urokinase combined with dexamethasone.The improvement of clinical symptoms and pleural thickness of two groups were compared.Levels of lung function[maximum expiratory flow(MEF),forced vital capacity(FVC)and forced expiratory volume in one second(FEV_(1))],hypersensitive C-reactive protein(hs-CRP)and tumor necrosis factor(TNF-α),T lymphocyte CD4^(+)and CD3^(+),tissue type plasminogen activator(t-PA)/plasminogen activator inhibitor 1(PAI-1)and typeⅢprocollagen(PC-Ⅲ)levels of two groups were detected,the therapeutic effects of two groups were compared.RESULTS:The disappearance time of chest tightness,pleural effusion and fever in combination group was shorter than that in dexamethasone group,and the pleural thickness was lower than that in dexamethasone group,with statistically significant differences(P<0.05).After treatment,the levels of MEF,FVC and FEV_(1) in combined group were higher than those in dexamethasone group,the levels of hs-CRP,TNF-αand PC-Ⅲwere lower than those in dexamethasone group,and the levels of CD4^(+),CD3^(+)and t-PA/PAI-1 were higher than those in dexamethasone group,with statistically significant differences(P<0.05).The total effective rate of combined group was 95.56%(43/45),higher than 80.00%(36/45)of dexamethasone group,the difference was statistically significant(P<0.05).CONCLUSIONS:The efficacy of minimally invasive thoracic catheterization assisted with urokinase combined with dexamethasone in the treatment of patients with tuberculous pleurisy is significant,which can effectively reduce the clinical symptoms,improve lung function,reduce inflammation,and improve immune function and fibrinolytic activity.
作者
王欢
金慧敏
WANG Huan;JIN Huimin(Dept.of Physical Diagnosis,Heilongjiang Provincial Hospital of Infectious Diseases,Harbin 150500,China;Dept.of Tuberculosis,Heilongjiang Provincial Hospital of Infectious Diseases,Harbin 150500,China)
出处
《中国医院用药评价与分析》
2024年第6期701-704,共4页
Evaluation and Analysis of Drug-use in Hospitals of China
关键词
结核性胸膜炎
胸腔微创置管
尿激酶
地塞米松
纤溶活性
免疫功能
Tuberculous pleurisy
Minimally invasive thoracic catheterization
Urokinase
Dexamethasone
Fibrinolytic activity
Immune function
