基于免疫功能、肺功能指标探究支气管镜介入治疗老年气管支气管结核的临床效果OA
Exploration of clinical efficacy of bronchoscopic interventional therapy in elderly patients with tracheobronchial tuberculosis based on immune and pulmonary function indicators
目的 探讨支气管镜介入治疗老年气管支气管结核(TBTB)的临床效果.方法 收集石家庄市第五医院2020年5月—2023年8月167例老年TBTB患者的临床资料,按治疗方法不同分为A组(n=57,接受支气管镜球囊扩张+局部注药治疗)、B组(n=56,接受支气管镜冷冻+局部注药治疗)、C组(n=54,接受支气管镜冷冻+球囊扩张+局部注药治疗),3组均接受常规抗结核及支气管镜介入治疗,共治疗3个月.比较3组痰菌转阴率、病灶好转率、疗效及不良反应发生情况,同时比较治疗前后肺功能指标[第1秒用力呼气容积(FEV1)、用力肺活量占预计值百分比(FVC%pred)、峰值呼气流速(PEF)]、炎症指标[红细胞沉降率(ESR)、白细胞介素-6(IL-6)、C反应蛋白(CRP)]及免疫指标(CD4+、CD3+、CD4+/CD8+).结果 C组痰菌转阴率、病灶好转率、总有效率均高于A组、B组(P<0.05).治疗后,C组FEV1、FVC%pred、PEF、CD4+、CD3+、CD4+/CD8+高于A组、B组,ESR、IL-6、CRP低于A组、B组(P<0.05);但A组与B组比较差异无统计学意义(P>0.05).3组不良反应总发生率比较差异无统计学意义(P>0.05).结论 支气管镜介入治疗老年TBTB效果显著,且冷冻治疗、球囊扩张、局部给药联合应用效果最佳,可促进痰菌转阴、病灶好转,改善肺功能和免疫功能,减轻炎症反应,且安全性高.
Objective To investigate the clinical efficacy of bronchoscopic interventional therapy for elderly patients with tracheobronchial tuberculosis(TBTB).Methods The clinical data of 167 elderly patients with TBTB admitted to the Fifth Hospital of Shijiazhuang City from May 2020 to August 2023 were collected.According to different treatment methods,they were divided into group A(n=57,treated with bronchoscopic balloon dilation+local drug injection),group B(n=56,treated with bronchoscopic cryotherapy+local drug injection),and group C(n=54,treated with bronchoscopic cryotherapy+balloon dilation+local drug injection).All three groups received routine anti-tuberculosis therapy and corresponding bronchoscopic intervention for a total of 3 months.The sputum negative conversion rate,lesion improvement rate,therapeutic efficacy and adverse reactions were compared among the three groups.Pulmonary function indicators[forced expiratory volume in one second(FEV1),percentage of predicted forced vital capacity(FVC%pred),peak expiratory flow(PEF)],inflammatory markers[erythrocyte sedimentation rate(ESR),interleukin-6(IL-6),C-reactive protein(CRP)]and immune indicators(CD4+,CD3+,CD4+/CD8+)before and after treatment were also compared.Results The sputum negative conversion rate,lesion improvement rate and total effective rate in group C were all higher than those in group A and group B(P<0.05).After treatment,FEV1,FVC%pred,PEF,CD4+,CD3+and CD4+/CD8+in group C were higher than those in group A and group B,while ESR,IL-6 and CRP were lower(P<0.05);however,there were no significant differences between group A and group B(P>0.05).There was no significant difference in the total incidence of adverse reactions among the three groups(P>0.05).Conclusion Bronchoscopic interventional therapy has remarkable efficacy for elderly patients with TBTB.The combination of cryotherapy,balloon dilation and local drug administration achieves the optimal therapeutic efficacy,which can promote sputum negative conversion and lesion improvement,improve pulmonary and immune function,relieve inflammatory response,and possess high safety.
苏天鹤;孙扬;周吉坤;田岳飏;申蕾蕾;李健
石家庄市第五医院结核二科,石家庄 050200石家庄市第五医院结核二科,石家庄 050200石家庄市第五医院医学研究所,石家庄 050200石家庄市第五医院检验科,石家庄 050200石家庄市第五医院结核二科,石家庄 050200石家庄市第五医院感染四科,石家庄 050200
气管支气管结核老年支气管镜介入免疫功能肺功能白细胞介素-6C反应蛋白
tracheobronchial tuberculosiselderlybronchoscopic interventionimmune functionpulmonary functioninterleukin-6C-reactive protein
《临床误诊误治》 2026 (15)
56-61,6
2025年度河北省医学科学研究课题计划(20251127)
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