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
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
王欢 1金慧敏2
作者信息
- 1. 黑龙江省传染病防治院物理诊断科,哈尔滨 150500
- 2. 黑龙江省传染病防治院结核内科,哈尔滨 150500
- 折叠
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(FEV1)]、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FEV1 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.
Abstract
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(FEV1)],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 type Ⅲ procollagen(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 FEV1 in combined group were higher than those in dexamethasone group,the levels of hs-CRP,TNF-α and PC-Ⅲ were 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.
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Key words
Tuberculous pleurisy/Minimally invasive thoracic catheterization/Urokinase/Dexamethasone/Fibrinolytic activity/Immune function引用本文复制引用
出版年
2024
国家科技期刊平台
NSTL
万方数据