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胸腔注射糖皮质激素联合标准四联抗结疗法对结核性胸膜炎患者临床症状及肺功能的影响
引用本文:马啸楠,初乃惠,刘长利,姚林明,王 欣.胸腔注射糖皮质激素联合标准四联抗结疗法对结核性胸膜炎患者临床症状及肺功能的影响[J].现代生物医学进展,2021(15):2868-2871.
作者姓名:马啸楠  初乃惠  刘长利  姚林明  王 欣
作者单位:首都医科大学附属北京胸科医院结核一科 北京 101149;陕西省结核病防治院结核内一科 陕西 西安710100
基金项目:"十三五"重大新药创制科技重大专项(2017ZX09304009)
摘    要:摘要 目的:探讨胸腔注射糖皮质激素联合标准四联抗结疗法对结核性胸膜炎患者肺功能及临床症状的影响。方法:选取2013年1月到2020年5月期间来我院进行诊治的结核性胸膜炎患者756例,入选的患者按照随机数字表法分为对照组和实验组,各378例。对照组予以标准四联抗结疗法治疗,实验组予以胸腔注射糖皮质激素联合标准四联抗结疗法治疗。对比两组疗效、肺功能第1s用力呼气容积占预计值百分比(FEV1%pred)、每分钟最大通气量占预计值百分比(MVV%pred)、用力肺活量占预计值百分比(FVC%pred)],记录两组胸水吸收时间、胸膜厚度、临床症状缓解时间、住院时间、并发症及胸膜肥厚粘连发生情况。结果:实验组的临床总有效率较对照组高(P<0.05)。治疗后,两组FEV1%pred、MVV%pred、FVC%pred均升高,且实验组高于对照组(P<0.05)。实验组临床症状缓解时间、胸水吸收时间、住院时间较对照组短(P<0.05),胸膜厚度大于对照组(P<0.05)。实验组的胸膜肥厚粘连、并发症总发生率低于对照组(P<0.05)。结论:胸腔注射糖皮质激素联合标准四联抗结疗法治疗结核性胸膜炎,疗效可靠,可改善患者肺功能,促进症状改善。

关 键 词:糖皮质激素  标准四联抗结疗法  结核性胸膜炎  肺功能  临床症状
收稿时间:2021/3/19 0:00:00
修稿时间:2021/4/14 0:00:00

Effect of Intrapleural Injection of Glucocorticoid Combined with Standard Quadruple Anti Tuberculous Therapy on Clinical Symptoms and Pulmonary Function of Patients with Tuberculous Pleurisy
Abstract:ABSTRACT Objective: To investigate the effect of intrapleural injection of glucocorticoid combined with standard quadruple anti tuberculous therapy on pulmonary function and clinical symptoms of patients with tuberculous pleurisy. Methods: 756 patients with tuberculous pleurisy from January 2013 to May 2020 were selected, the enrolled patients were randomly divided into control group and experimental group according to random number table method, 378 cases in each group. The control group was treated with standard quadruple anti tuberculous therapy, and the experimental group was treated with intrapleural injection of glucocorticoid combined with standard quadruple anti tuberculous therapy. The curative effect, pulmonary function percentage of forced expiratory volume in predicted value in 1s (FEV1%pred), maximum ventilation volume per minute as a percentage of predicted value (MVV%pred), forced vital capacity as a percentage of predicted value (FVC%pred)] were compared between the two groups. Pleural fluid absorption time, pleural thickness, clinical symptom remission time, hospitalization time, complications and pleural hypertrophy adhesion were recorded between the two groups. Results: The total effective rate of the experimental group was higher than that of the control group (P<0.05). After treatment, FEV1%pred, MVV%pred and FVC%pred of the two groups were increased, and the experimental group was higher than the control group(P<0.05). The clinical symptom remission time, pleural fluid absorption time and hospitalization time of the experimental group were shorter than those of the control group(P<0.05), and the pleural thickness of the experimental group was greater than that of the control group(P<0.05). The total incidence rate of pleural hypertrophy adhesion and complications of the experimental group were lower than those of the control group (P<0.05). Conclusion: The intrapleural injection of glucocorticoid combined with standard quadruple anti tuberculous therapy in the treatment of tuberculous pleurisy has a reliable effect, which can improve the pulmonary function and promote the improvement of symptoms.
Keywords:Intrapleural injection of glucocorticoid  Standard quadruple anti tuberculous therapy  Tuberculous pleurisy  Pulmonary function  Clinical symptoms
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