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目的:观察胸腺素α1联合抗结核药物治疗糖尿病合并肺结核的临床效果。方法:选择糖尿病合并肺结核67例,随机分为观察组34例和对照组33例。对照组给予常规降血糖和抗结核治疗,观察组在对照组基础上加用胸腺素α1皮下注射治疗,疗程6个月。观察比较两组临床症状改善情况,外周血T细胞亚群、自然杀伤(NK)细胞等比例和血清免疫球蛋白A(Ig A)、免疫球蛋白G(IgG)、免疫球蛋白M(IgM)水平,以及不良反应发生情况。结果:观察组痰菌阴转率、空洞吸收率均较对照组显著提高(P<0.05),发热和咳嗽情况亦较对照组显著改善(P<0.05)。治疗6个月后,观察组CD3+T细胞、CD4+T细胞、NK细胞比例,以及CD4+T细胞/CD8+T细胞值和血清IgG水平,均较对照组显著升高(P<0.05);CD8+T细胞比例较对照组显著降低(P<0.05);IgA、IgM水平与对照组比较差异不显著(P>0.05)。两组治疗期间不良反应发生率比较,差异不显著(P>0.05)。结论:胸腺素α1联合抗结核药物治疗糖尿病合并肺结核,可显著改善免疫功能,提高临床疗效,且较安全。
Objective: To observe the clinical effect of thymosin α1 combined with anti-tuberculosis drugs in treating diabetic patients with pulmonary tuberculosis. Methods: Sixty-seven cases of diabetes combined with pulmonary tuberculosis were randomly divided into observation group (34 cases) and control group (33 cases). The control group was given conventional hypoglycemic and anti-TB treatment. The observation group was given subcutaneous injection of thymosin α1 on the basis of the control group for 6 months. The clinical symptom improvement, peripheral blood T cell subsets, natural killer (NK) cell ratio and serum immunoglobulin A (Ig A), immunoglobulin G (IgG), immunoglobulin M (IgM) Level, and the occurrence of adverse reactions. Results: The negative conversion rate and empty absorption rate of sputum in the observation group were significantly higher than those in the control group (P <0.05). The fever and cough were also significantly improved (P <0.05) compared with the control group. After 6 months of treatment, the levels of CD3 + T cells, CD4 + T cells, NK cells, CD4 + T cells / CD8 + T cells and serum IgG in the observation group were significantly higher than those in the control group (P <0.05) ; The proportion of CD8 + T cells was significantly lower than that of the control group (P <0.05); IgA and IgM levels were not significantly different from the control group (P> 0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P> 0.05). Conclusion: Thymosin α1 combined with anti-tuberculosis drugs in the treatment of diabetes mellitus combined with pulmonary tuberculosis, can significantly improve immune function, improve clinical efficacy, and more secure.