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目的:探讨双环醇预防抗结核药物所致肝功能损害的临床疗效及对T淋巴细胞亚群影响,观察药物性肝损害的发生率及研究其是否具有免疫调节作用。方法:采用前瞻性研究,对66例初治菌阳肺结核患者随机分为治疗组和对照组,治疗组强化抗痨加双环醇片,对照组强化抗痨加肝泰乐,疗程6个月。并用用流式细胞术(FCM)测定外周血中的T淋巴细胞亚群水平。结果:治疗组的患者肝损害发生率5.6%,而对照组发生率16.7%,两组比较差异显著(P<0.01);两组在治疗前及治疗后2个月、6个月比较,其外周血CD4+、CD8+及CD4+/CD8+也存在明显的差异(P<0.01)。治疗组双环醇使用6个月后与对照组比较,其CD4+明显升高,CD8+降低,两组比较差异有显著性(P<0.05)。结论:双环醇能有效预防抗结核药物所致肝功能损害,安全性好,无明显副作用,有利于患者顺利完成抗结核疗程,其亦有助于CD4+细胞水平增加及CD8+细胞水平降低。
OBJECTIVE: To investigate the clinical efficacy of bicyclol in preventing liver damage caused by antituberculosis drugs and its effect on T lymphocyte subsets, and to observe the incidence of drug-induced liver damage and to study whether it has immunomodulatory effects. Methods: A prospective study of 66 patients with newly diagnosed bacillary positive pulmonary tuberculosis was randomly divided into treatment group and control group. The treatment group was given anti-tuberculosis plus anti-dicycloheptan, and the control group was anti-tartar plus tylosin for 6 months. The level of T lymphocyte subsets in peripheral blood was determined by flow cytometry (FCM). Results: The incidence of liver damage in the treatment group was 5.6%, while that in the control group was 16.7%. There was significant difference between the two groups (P <0.01). Before treatment and at 2 and 6 months after treatment, There were also significant differences in CD4 +, CD8 + and CD4 + / CD8 + levels in peripheral blood (P <0.01). Compared with the control group, the level of CD4 + and the level of CD8 + in the treatment group after 6 months of treatment were significantly decreased (P <0.05). CONCLUSION: Bicyclol can effectively prevent the damage of liver function caused by antituberculosis drugs. It is safe and has no obvious side effects. It is favorable for patients to successfully complete antituberculous therapy. It also contributes to the increase of CD4 + cells and the decrease of CD8 + cells.