莫西沙星联合纤维支气管镜药物灌注对耐多药肺结核患者T细胞亚群、肺功能和肝功能的影响

摘要 目的：探讨莫西沙星联合纤维支气管镜药物灌注对耐多药肺结核患者T细胞亚群、肺功能和肝功能的影响。方法：选取2017年2月~2018年12月期间我院收治的90例耐多药肺结核患者，根据随机数字表法分为对照组（n=45，常规基础治疗）和研究组（n=45，莫西沙星联合纤维支气管镜药物灌注），比较两组患者痰菌转阴率、病灶吸收率、T细胞亚群、肺功能和肝功能。结果：研究组治疗6个月后的痰菌转阴率为88.89%（40/45），高于对照组的68.89%（31/45）（P<0.05）。研究组治疗6个月后的病灶吸收率为84.44%（38/45），高于对照组的64.44%（29/45）（P<0.05）。两组治疗6个月后第1 s用力呼气容积（FEV₁）、用力肺活量（FVC）、每分钟最大通气量（MVV）占预计值百分比、总蛋白(TP)、CD4⁺、CD4⁺/CD8⁺均升高，且研究组高于对照组（P<0.05）；丙氨酸氨基转移酶(ALT)、门冬氨酸氨基转移酶(AST)、CD8⁺均降低，且研究组低于对照组（P<0.05）。结论：莫西沙星联合纤维支气管镜药物灌注治疗耐多药肺结核，可有效阻止疾病进展，同时在改善患者T细胞亚群、肺功能和肝功能方面效果显著。

The Effect of Moxifloxacin Combined with Fiberbronchoscopy on T Cell Subsets, Lung Function and Liver Function in Multidrug Resistant Tuberculosis Patients

ABSTRACT Objective: To investigate the effect of moxifloxacin combined with bronchofiberscope on T cell subsets, lung function and liver function in Multidrug resistant tuberculosis patients. Methods: 90 Multidrug resistant tuberculosis patients in our hospital from February 2017 to December 2018 were selectd, they were divided into control group (n=45, routine basic treatment) and study group (n=45, moxifloxacin combined with bronchofiberscope drug perfusion) according to the random number table method. The sputum negative rate, focus absorption rate, T cell subsets, lung function and liver function were compared between the two groups. Results: The sputum negative rate of the study group was 88.89% (40/45), which was higher than 68.89% (31/45) of the control group (P<0.05). The absorption rate of focus in the study group was 84.44% (38/45), which was higher than 64.44% (29/45) in the control group (P<0.05). After 6 months of treatment, forced expiratory volume (FEV₁), forced vital capacity (FVC), and maximum ventilation volume per minute (MVV) as a percentage of the predicted value, the total protein (TP), CD4⁺, CD4⁺/ CD8⁺ in the first second in the two groups were higher than those of the control group, and the study group were higher than the control group (P<0.05). Alanine aminotransferase (ALT), aspartate aminotransferase (AST) and CD8⁺ decreased, and the study group was lower than that in the control group(P<0.05). Conclusion: Moxifloxacin combined with fiberbronchoscopic drug perfusion can effectively prevent the progress of the disease and improve the T cell subsets, lung function and liver function of the patients.