ABSTRACT
Objective To investigate the effects of levofloxacin on serum interlukin 6(IL-6) and interferon γ(IFN-γ) levels in the treatment of elderly patients with pulmonary tuberculosis.Methods A total of 87 senile pulmonary tuberculosis patients were collected and randomly divided into experiment group and control group.43 patients in the control group were given standardized treatment, 44 patients in the experiment group were treated on the basis of the control group were given levofloxacin, the total treatment was 6 months.By comparing serum IL-6 and IFN-γlevels changes of the patients before and after treatment and negative conversion ratio after treatment and degree of lesions changes of the two groups ,the effects of levofloxacin on pulmonary tuberculosis were explored.Results Compared with before treatment in the two groups, serum IL-6, IFN-gamma levels were significantly lower after treatment, the above indexes in experiment group were higher than those in control group (P<0.05).After 6 months treatment, negative conversion ratio in sputum bacteria in control group was 30 cases (69.77%), and 40 cases (90.91%)in experiment group, with significant difference ( P<0.05).Of the control group, the significant absorption, absorption and deterioration was respectively 22 cases (51.16%), 8 cases (18.60%), 13 cases (27.90%),of the experiment group was 31 cases (70.45%), 9 cases (20.45%), 4 cases (9.09%),respectively.The total lesions absorption rate of the experiment group (90.91%) was significantly higher than control group (69.77%) (P<0.05).Conclusion Levofloxacin in the treatment of senile patients with pulmonary tuberculosis can reduce serum IL-6 and IFN-γlevels, improve the patients'negative conversion ratio of sputum bacteria and total lesions absorption rate, has a good effect for the treatment.
ABSTRACT
Objective To explore and evaluate the predictive value of the coagulopathy in patients with community-acquired pneumonia (CAP).Methods A retrospective study was carried out for investigating the prothrombin time (PT),activated partial thromboplastin time (APTT),plasma fibrinogen (FIB),thrombin time (TT),plateslets (PLT),D-dimer in 385 patients with CAP and 146 patients without infection,tumor,trauma,thrombosis as controls.All the patients were admitted to the Respiratory Medical Department from June,2010 to May,2011.The results of the aforementioned biomarkers were analyzed and compared between two groups.The Pneumonia Severity Index (PSI) was calculated to evaluate the correlation between coagulopathy and PSI.Results The comparisons of the abnormal rates of PLT,PT,APTT,Fib,D-dimer between the patients with CAP and the controls were 92/385 vs.9/146,39/385 vs.1/146,108/385 vs.7/ 146,331/385 vs.47/146,348/385 vs.5/146,respectively.The differences were statistically significant (x2 =21.608,13.557,33.747,149.280,365.619,respectively,P ＜ 0.01),while difference in TT was not statistically significant (8/385 and 0/146,x2 =1.839,P ＞ 0.05).The differences in abnormal rate of PLT,PT,D-dimer between high-risk group of CAP and the low-risk group of CAP were 45/148 vs.47/237,26/148 vs.13/237,146/148vs.202/237,respectively,and the differences were statistically significant (x2 =5.602,14.609,23.442,respectively,P ＜0.05),while there were no differences in TT,APTT,FIB between two groups (6/148 vs.2/237,47/148 vs.61/237,123/148 vs.208/237,x2 =4.614,1.635,1.638,respectively,P ＞0.05).D-dimer in patients with CAP was (3.8 ±6.1) mg/L,compared with the controls (0.3 ±0.1) mg/L,and D-dimer in high-risk patients with CAP was (7.5 ±8.3) mg/L compared with the low-risk group (1.6 ±2.0) mg/L (P ＜ 0.001).Rank correlation existed between D-dimer and PSI (r =0.798,P ＜ 0.01),while there was no correlation between PLT and PSI (x2 =6.040,P ＞0.05).Conclusions The coagulopathy commonly occurs in patients with CAP.D-dimer was significantly higher in patients with CAP.D-dimer level is positively correlated with severity of CAP.D-dimer can be an ideal biomarker to assess the severity of patients with CAP.