重组人白细胞介素-Ⅱ辅助治疗复治肺结核临床观察

摘要/Abstract

摘要： 目的　研究和评价重组人白细胞介素-Ⅱ(IL-2)辅助治疗肺结核的临床效果。方法选痰菌阳性复治肺结核43例,观察组22例,采用2HL₂AK(E)Z(TH)V+IL-2/1HL₂(TH)V+IL-2/5HL₂V方案化疗；对照组21例,采用2HL₂AK(E)Z(TH)V/1HL₂(TH)V/5HL₂V方案化疗。结果完成疗程可评价疗效者40例,其中观察组20例,对照组20例,观察组痰菌阴转、病灶吸收、空洞的缩小和闭合以及免疫检测结果均优于对照组。无严重不良反应发生。结论重组人IL—2有辅助治疗肺结核的作用,可加速结核菌阴转速度,促进病灶吸收,提高机体免疫力,是安全可靠的生物制剂。

关键词: 结核,肺, 白细胞介素-Ⅱ, 临床研究

Abstract: Objective To study and evaluate the clinical effects of adjunctive immunotherapy with recombinant human IL-2 in adults with retreatment pulmonary tuberculosis. MethodForty-three sputum smear positive retreatment TB patients were enrolled into this study. There are 22 cases in intervention group and 21 cases in control group. The chemotherapeutic regime which was 2HL2AK(E)Z(TH)V+IL-2/1HL2(TH)V+IL-2/5HL2V in intervention group and 2HL2AK(E)Z(TH)V/1H L2(TH)/5HL2V in control group. ResultForty patients completed the treatment course, their outcome were evaluated. Among of them, 20 patients from intervention group and 20 patients from control group. The sputum smear-conversion, lesion absorbed, cavity shrunk and immune test Results in intervention group were better than that of control group. There were no severe side-effects among patients received IL-2 for treatment. ConclusionThe study suggest that the recombinant IL-2 would be not only a safe biological agent, but also an adjunctive immunotherapy for retreatment pulmonary tuberculosis, which can facilitate smear , lesion absorbed, immunity of patients with pulmonary tuberculosis.

Key words: Pulmonary tuberculosis, IL-2, Clinical study

张红梅,吴卫华,韩志荣,郑华,梁瑞武,李宝兰,. 重组人白细胞介素-Ⅱ辅助治疗复治肺结核临床观察[J]. 中国防痨杂志, 2005, 27(4): 219-223.

Zhang Hongmei, Wu Weihua, Han Zhirong, et al.. The clinical observation on adjunctive immunotherapy with recombinant human IL-2 in adults with retreatment pulmonary tuberculosis[J]. Chinese Journal of Antituberculosis, 2005, 27(4): 219-223.

参考文献

1 刘延龙,李冀文，王孟山.结核分支杆菌耐药基因的研究进展[J].中华结核和呼吸杂志,1996,19:364
2 Johnson BJ,Bekker LG,Rickman R, et al.rhuIL-2 abjunctive thereby in multidnig resistant tuberculoeia: a comparison of two treatment regimens and placebo[J] .Tuber Lung Dis,1997,78:195～203
3 Johnson BJ. Estrada I,Shen Z, et al. Differential gene egression in resqonse to adjunctive recombinant human intedeukin-2 immunotherapy in multidnig-resistant tuberculosis patients[J].Infect Immun, 1998,66:2426～2433
4 Johnson BJ,Hess SR, Willcox P,et al.Clinical and immune responses of tuberculosis patients treated with low-dose IL-2 and multidiug therapy[J]. Cytokines Mol Ther,1995,1:185～196
5 Johnson JL,Saekasanvu E,Okwera A,et al. Randomized trial of adjunctive interleukin-2 in adults with pulmonaiy tubertulosis[J]. Am J Respir Crit Care Med,2003,168:185～191
6 初乃惠,朱丽贞，马丽萍等.重组人白细胞介素-2辅助治疗复治肺结核近期疗效观察[J].中华结核和呼吸杂志，2003,26:548～551
7 中华医学会结核病学分会.肺结核诊断和治疗指南[J].中华结核和呼吸杂志.2001；24:70～74
8 Smith KA. Interieukin-2：incepticni, impact,and implications[j].Science 1988;240:1169～1176
9 Khanna M,Srivastava LM, Kumar P. Defective interleukin-2 production and interleukin-2 receptor expression in pulmonary tuberculosis [J]. J Commun Dis,2003,35:65～70
10 Leonard WJ, Depper JM, Crabtree GR, et al. Molecular cloning and expression of cDNAs for the human interleukin-2 receptor[J].Nature,1984,311:626～631
11 Nikaido T, Shimizu A, Ishida N, et al. Molecular cloning of cDNA encoding human interleukin-2 receptor[J].Nature,1984,311:631～635
12 Rubin LA.Nolson DL.The soluble interieukin-2 receptor: biology function and clinical applicalion[J]. Ann intern Med, 1990,113:619～627
13 Aviles Ingles MJ,Contessotto C，Ontanon Rodriguez J, et al. Serum soluble interleukin-2 receptor： a useful indicator of the clinical course in pulmonary tuberculosis[J] .Tuber Lung Dis. 1995,76(2):130～135
14 Chan CH,Lai CK,Leung JC,et al. Elevated interleukin-2 receptor level in patients with active pulmonary tuberculosis and the changes following anti-tuberculosis chemotherapy[J]. Eur Respir J,1995,8:70～73
15 Takahashi S,Setoguchi Y,Nukiwa T,et al.Soluble interleukin-2 receptor in sera of patients with pulmonary tuberculosis[J]. Chest, 1991,99:310-314

[1]	陈燕琴,. 69例妊娠并发肺结核患者的临床治疗[J]. 中国防痨杂志, 2018, 40(12): 1313-1318.
[2]	蒋钰辉刘小玉盛健戴希勇. 原发与继发结核性脓胸手术治疗的早期临床观察[J]. 中国防痨杂志, 2017, 39(3): 312-314.
[3]	宋瑞娟李锋卢水华. 间充质干细胞辅助治疗耐多药结核病的研究进展[J]. 中国防痨杂志, 2017, 39(3): 299-303.
[4]	张亚楠段鸿飞. 鸟-胞内分枝杆菌复合群肺病的诊断和治疗进展[J]. 中国防痨杂志, 2017, 39(10): 1126-1129.
[5]	袁保东,王卫华,段琼红,张炎林,陆兰英. 耐多药肺结核患者生命质量的评价[J]. 中国防痨杂志, 2006, 28(3): 139-142.
[6]	刘国标,张丽好,何霞,温文沛,杜雨华,. 广州市初治涂阳肺结核患者治疗2个月末痰涂片不阴转原因探讨[J]. 中国防痨杂志, 2005, 27(6): 360-363.
[7]	张宇青,吴龙章,黄洁玲,李嫣红,王云南,谢贝,黄丽晶,. 脓肿分枝杆菌肺病47例临床分析[J]. 中国防痨杂志, 2005, 27(5): 313-315.
[8]	周琳,云径平,张广莉,陈树忠,骆燕鸣,. 72例鼻咽结核的临床分析[J]. 中国防痨杂志, 2005, 27(4): 241-243.
[9]	吕青,. 结核性多发浆膜炎45例临床分析[J]. 中国防痨杂志, 2003, 25(2): 92-94.
[10]	刘宝华,张长青,宋自卫,. 结核性胸膜炎的临床特征(附345例分析)[J]. 中国防痨杂志, 2002, 24(5): 261-263.
[11]	蒋迎九,罗永艾,李朝先,向小勇,. 食管结核164例临床分析[J]. 中国防痨杂志, 2002, 24(4): 197-199.
[12]	褚海青, 李惠萍, 何国钧, . 社区获得性快生长型非结核分支杆菌肺病58例临床分析[J]. 中国防痨杂志, 2000, 22(2): 72-73.