Objective To investigate the efficacy and safety of prednisone combined with standard quadruple antituberculosis therapy(HRZE)in the treatment of tuberculous pleurisy.Methods A prospective study was conducted involving 120 patients with tuberculous pleurisy who were admitted to the Shaanxi Provincial Tuberculosis Prevention and Control Hospital from February 2021 to February 2023.The patients were randomly assigned to a study group and a control group,with 60 patients in each group,using a computer-generated randomization method.The control group received HRZE alone,while the study group received prednisone therapy and HRZE.The efficacy,clinical indicators,adverse reactions,and serum inflammatory factor levels were compared between the two groups.Results The total response rate in the study group was significantly higher than that in the control group[93.33％(56/60)vs.78.33％(47/60),x2=5.55,P＜0.05).In the study group,the time for clinical symptom improvement was(10.34±1.65)days,the time for pleural effusion absorption was(21.37±4.16)days,the pleural thickness measured(2.15±0.35)mm,and the duration of hospitalization was(23.19±4.56)days.They were significantly shorter or smaller than those in the control group[(13.27±2.30)days,(27.25±4.95)days,(2.62±0.40)mm,(28.42±5.60)days,t=8.02,7.04,6.85,5.61,all P＜0.05].There was no significant difference in the incidence of adverse reactions between the two groups(x2=2.91,P＞0.05).After 8 weeks of treatment,all serum inflammatory factors improved in both groups compared with baseline levels.In the study group,levels of interleukin-6[(90.37±12.05)ng/L]and interleukin-18[(270.94±14.58)ng/L]were significantly lower than those in the control group[(110.59±16.90)ng/L,(296.10±25.29)ng/L,t=7.55,6.68,both P＜0.05].Levels of interleukin-10[(78.91±8.25)ng/L]and soluble interleukin-2 receptor[(1875.82±359.23)pg/L]in the study group were significantly higher than those in the control group[(70.40±7.16)ng/L,(1566.87±311.02)pg/L,t=-6.03,-5.04,both P＜0.05].Conclusion The combination of prednisone and HRZE demonstrates good efficacy and safety,and it is beneficial for improving inflammatory factors.
Tuberculosis,PleuralAntitubercular agentsPrednisoneInterleukin-10Drug-related side effects and adverse reactionsTreatment outcome
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