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

Liu Hongwu

Li Dandan

Zhang Hong

Guo Peiyan

Zhu Ying

Department of Respiratory and Critical Care Medicine,Seventh Medical Center of the People's Liberation Army General Hospital

Abstract:Objective To investigate the effects of the 4 MRZE chemotherapy regimen on the immune system, inflammatory 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 Medicine, 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 4 MRZE chemotherapy regimen, while the control group was treated with the 2 HRZE/4 HR regimen. The clinical efficacy and adverse reactions of the two groups were observed. Before 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 interleukin-8(IL-8), as well as tuberculosis-related proteins including gelsolin(GSN), α1-acid glycoprotein(AAG), and heparin-binding protein(HBP) were also measured. Results The total effective rate of the observation group was higher than that of the control group(χ2/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 lower 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 observation 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(χ2/P = 3.970/0.046). Conclusion The 4 MRZE chemotherapy regimen for the treatment of PSSPTB can improve therapeutic efficacy, enhance the body' s immunity, alleviate inflammatory responses, optimize the levels of tuberculosisrelated proteins, and reduce adverse reactions.

Keyword:Tuberculosis4MRZE chemotherapy regimenBody immunityInflammatory factorsTuberculosis-associated proteinTherapeutic efficacy

Fund:Development and Research Special Project of Beijing Municipal Health Commission (Shoufa,2024-2-5094)