疑难病杂志2026，Vol.25Issue(4)：446-450,5.DOI:10.3969/j.issn.1671-6450.2026.04.012
4MRZE化疗方案对初治涂阳肺结核患者机体免疫、炎性因子、结核相关蛋白的影响
The influence of the 4MRZE chemotherapy regimen on the immune system,inflammatory factors and tuberculosis-related proteins of patients with pulmonary primary sputum smear-positive tuberculosis
摘要
Abstract
Objective To investigate the effects of the 4MRZE chemotherapy regimen on the immune system,in-flammatory factors,and tuberculosis-related proteins in patients with pulmonary primary sputum smear-positive tuberculosis(PSSPTB).Methods A total of 80 patients with PSSPTB admitted to the Department of Respiratory and Critical Care Medi-cine,Seventh Medical Center of the People's Liberation Army General Hospital from January 2022 to December 2024 were selected.According to the random number table method,they were respectively assigned to the observation group(n=40)or the control group(n=40).The observation group was treated with the 4MRZE chemotherapy regimen,while the control group was treated with the 2HRZE/4HR regimen.The clinical efficacy and adverse reactions of the two groups were observed.Be-fore and after treatment,the levels of T cell subsets including CD3+,CD4+,CD8+and CD4+/CD8+ratio in the serum of the two groups were measured.Inflammatory factors such as tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),and interleu-kin-8(IL-8),as well as tuberculosis-related proteins including gelsolin(GSN),α1-acid glycoprotein(AAG),and heparin-bind-ing protein(HBP)were also measured.Results The total effective rate of the observation group was higher than that of the control group(x2/P=7.347/0.007).After treatment,the levels of CD3+,CD4+,and CD4+/CD8+ratio in the observation group were higher than those in the control group,while CD8+level was lower than that in the control group(t/P=3.994/＜0.001,4.433/＜0.001,8.148/＜0.001,3.689/＜0.001).The levels of serum TNF-α,IL-6,and IL-8 in the observation group were all low-er than those in the control group(t/P=14.102/＜0.001,8.032/＜0.001,6.044/＜0.001).The GSN and HBP levels in the observa-tion group were lower than those in the control group,and the AAG level was higher than that in the control group(t/P=5.478/＜0.001,5.141/＜0.001,2.556/0.013).The incidence of adverse reactions in the observation group was lower than that in the control group(x2/P=3.970/0.046).Conclusion The 4MRZE chemotherapy regimen for the treatment of PSSPTB can im-prove therapeutic efficacy,enhance the body's immunity,alleviate inflammatory responses,optimize the levels of tuberculosis-related proteins,and reduce adverse reactions.关键词
肺结核/4MRZE化疗方案/机体免疫/炎性因子/结核相关蛋白/疗效Key words
Tuberculosis/4MRZE chemotherapy regimen/Body immunity/Inflammatory factors/Tuberculosis-asso-ciated protein/Therapeutic efficacy分类
医药卫生引用本文复制引用
刘洪武,李丹丹,张红,郭沛艳,朱莹..4MRZE化疗方案对初治涂阳肺结核患者机体免疫、炎性因子、结核相关蛋白的影响[J].疑难病杂志,2026,25(4):446-450,5.基金项目
北京市卫生健康委员会发展科研专项项目(首发2024-2-5094) Development and Research Special Project of Beijing Municipal Health Commission(Shoufa,2024-2-5094) （首发2024-2-5094）
