Abstract：Objective: To observe the clinical efficacy of isoniazid combined with glucocorticoids in the treatment of tuberculous pleurisy. Methods:120 patients with tuberculous pleurisy admitted to the infections department of the hospital from June 2016 to March 2018 were chosen and divided into two groups by simple randomization method. The control group (n=60) was given conventional anti-tuberculosis treatment and chest drainage, the observation group (n=60) was given transthoracic injection of isoniazid combined with glucocorticoid on the basis of conventional treatment; the clinical efficacy, symptom improvement status, and lung function index[lung capacity percentage taking estimated value (VC%pred), forced lung capacity percentage taking estimated value(FVC%pred), total lung volume as a percentage of predicted value (TLC%pred)] changes before and after treatment and inflammatory factors in pleural effusion [transforming growth factor-β1 (TGF-β1), interleukin-6 (IL-) 6), tumor necrosis factor-α (TNF-α)] changes were compared between the two groups. Results: The effective rate of treatment in the observation group (91.67%)was significantly higher than in the control group (76.67) (P<0.05). The changes of pleural effusion and pleural thickness in the observation group were significantly more than those in the control group (P<0.05), and the pleural fluid absorption time was significantly shorter than that in the control group (P<0.05), the incidence of pleural thickening was significantly lower than that in the control group (P<0.05). After treatment, the increase of VC%pred, FVC%pred, TLC%pred and the decrease of TGF-β1, IL-6 and TNF-α levels in the observation group were significantly higher than those in the control group (P<0.05). Conclusion: Intrathoracic injection of isoniazid combined with glucocorticoids is effective in the treatment of tuberculous pleurisy, which can promote the loss of pleural effusion and reduce the occurrence of pleural hypertrophy
皇甫彤, 王伟红, 魏丽. 异烟肼联合糖皮质激素治疗结核性胸膜炎的临床疗效分析[J]. 河北医学, 2019, 25(3): 650-653.
HUANGFU Tong, et al. Clinical Efficacy of Isoniazid Combined with Glucocorticoid in the treatment of Tuberculous Pleurisy. HeBei Med, 2019, 25(3): 650-653.
[1] 陶冠宇,杨仁旭,任焱,等.卷曲霉素联合莫西沙星胸腔注射对结核性胸膜炎患者血清和胸腔积液IFN-γTNF-αCEA ADA水平的影响[J].河北医学,2018,24(6):898~902. [2] 任清泉,杨扬,张孟斌,等.不同引流方式治疗单纯结核性胸膜炎疗效分析[J].中国地方病防治杂志,2015,30(4):315~315. [3] Quan-Jun H U,Surgery D O,Hospital Q C.Curative effect of glucocorticoid in treatment of tuberculous pleuritic and effect on the inflammatory cell factors[J].China&Foreign Medical Treatment,2017,35(2):1235~1241. [4] 张培元.肺结核诊断和治疗指南[J].中华结核和呼吸杂志,2001,24(2):70~74. [5] 童建林,汪明雪,唐从发,等.内科胸腔镜在老年胸腔积液患者68例中的应用[J].重庆医学,2015,44(1):47~49. [6] 胡云衢,张凯,雷华君,等.中心静脉导管引流联合异烟肼及甲强龙胸腔内注射治疗结核渗出性胸膜炎的疗效[J].武警医学,2018,29(3):301~302. [7] 黄娟,雍小兰,罗涵,等.异烟肼在结核性胸膜炎患者胸水中的药代动力学研究[J].解放军药学学报,2017(4):342~344. [8] 周清平,尹玲,陈雯,等.常规抗结核联合异烟肼、地塞米松胸腔内注射治疗结核性胸膜炎的临床疗效分析[J].中南医学科学杂志,2017,45(4):385~387. [9] 胡心浩.结核性胸膜炎患者应用糖皮质激素治疗对ADA、Th1/Th2及炎症因子的影响[J].临床和实验医学杂志,2016,15(19):1918~1921.
2019, Vol. 25 
冀公网安备13080202000677号