母牛分枝杆菌疫苗治疗肺结核的临床研究
[A clinical study on vaccine of Mycobacterium vaccae in treating pulmonary tuberculosis].
作者信息
Wang W, Jin G, Ye Y, Xia X, Wang A, Zhuang Y, Li G, Sun H, Wang Z, Lin M, Chen H, Li J, Dan Z, Zhang X
机构信息
Department of Tuberculosis, 309th Hospital, PLA, Beijing 100091.
出版信息
Zhonghua Jie He He Hu Xi Za Zhi. 1999 Feb;22(2):108-10.
OBJECTIVE
To study the effect of vaccine of Mycobacterium vaccae on cell-mediated immunity and on treating patients with pulmonary tuberculosis.
METHODS
Seventy cases of pulmonary tuberculosis with smear positive and initial treatment were classified randomly into group I (35 cases) and group II (35 cases), receiving 2HRZS/4HR and 2HRZS/4HR plus vaccine of Mycobacterium vaccae regimens respectively. Thirty-one multi-drug resistant pulmonary tuberculosis cases were classified into group III, receiving 4 - 6 sensitive antituberculous drugs and vaccine of Mycobacterium vaccae. Improvement of clinical symptoms, resolution of pulmonary lesions, negative conversion of sputum and changes of immunological functions were observed.
RESULTS
No significant difference in improvement of symptoms was found in group I and group II (P > 0.05), and the improvement rate of clinical symptoms in group III was found more than 50%. X-ray resolution rates in 4th month were 83% and 89%, and cavity reducing rates 40% and 50% respectively in group I and group II, and no significant differences were found (P > 0.05). X-ray resolution rate was 29%, cavity reducing rate 7% and no deteriorated case was found in group III. Sputum negative conversion rates in 1st, 2nd, 3rd and 4th month were 23%, 51%, 83% and 97% respectively in group I, while 31%, 77%, 89% and 100% in group II, and 3%, 16%, 29% and 32% in group III. Significant difference was found between group I and group II in sputum negative conversion rate in 2nd month after treatment (P < 0.05). After treatment, values of lymphocyte transformation test (LTT), CD(3), CD(4) and CD(4)/CD(8) of the above 3 groups were all higher than that before the treatment (P < 0.05), level of tumor necrosis factor decreased in group II and IL-2, IL-6 increased in group III.
CONCLUSIONS
Vaccine of Mycobacterium vaccae is a good immunotherapy preparation, which promotes sputum negative conversion and activation of cell-mediated immunity.
目的
研究母牛分枝杆菌疫苗对细胞介导免疫及肺结核患者治疗的影响。
方法
将70例初治涂阳肺结核患者随机分为Ⅰ组（35例）和Ⅱ组（35例），分别采用2HRZS/4HR和2HRZS/4HR加母牛分枝杆菌疫苗方案治疗。31例耐多药肺结核患者分为Ⅲ组，采用4 - 6种敏感抗结核药物加母牛分枝杆菌疫苗治疗。观察临床症状改善情况、肺部病变吸收情况、痰菌转阴情况及免疫功能变化。
结果
Ⅰ组和Ⅱ组症状改善情况差异无统计学意义（P>0.05），Ⅲ组临床症状改善率>50%。Ⅰ组和Ⅱ组第4个月时X线吸收率分别为83%和89%，空洞缩小率分别为40%和50%，差异无统计学意义（P>0.05）。Ⅲ组X线吸收率为29%，空洞缩小率为7%，无病情恶化病例。Ⅰ组第1、2、3、4个月痰菌转阴率分别为23%、51%、83%和97%，Ⅱ组分别为31%、77%、89%和100%，Ⅲ组分别为3%、16%、29%和32%。治疗后第2个月时Ⅰ组和Ⅱ组痰菌转阴率差异有统计学意义（P<0.05）。治疗后，上述3组淋巴细胞转化试验（LTT）、CD(3)、CD(4)及CD(4)/CD(8)值均高于治疗前（P<0.05），Ⅱ组肿瘤坏死因子水平降低，Ⅲ组IL-2、IL-6升高。
结论
母牛分枝杆菌疫苗是一种良好的免疫治疗制剂，可促进痰菌转阴及激活细胞介导免疫。
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