摘要目的 观察提高免疫力治疗慢性布鲁菌病(简称布病)病例效果,对其疗效进行分析与评价.方法 对1例慢性布病患者采用蒙西药联合提高免疫力治疗,对比治疗前后患者的临床症状、血清学抗体、布鲁菌DNA、免疫功能水平.布鲁菌抗体检测采用试管凝集试验(SAT)和虎红平板凝集试验(RPBT);血细胞和血清中布鲁菌DNA采用PCR检测;外周血淋巴细胞亚群采用流式细胞进行分析检测;血清免疫球蛋白和补体成分采用免疫发光技术检测.结果 治疗后患者背部冰冷、周身乏力、关节疼痛等临床症状消失;治疗后血清学抗体SAT 1∶50(++),RPBT(+),与治疗前相比无变化;治疗前布鲁菌DNA检测为细胞阳性和血清阴性,治疗后均为阴性;免疫功能检测治疗后γδT细胞为9.50％,较治疗前(14.00％)有所下降;单核细胞和调节性T细胞(Treg)治疗后分别为5.59％和7.33％,均较治疗前(3.35％和4.72％)有所升高;补体C3水平治疗前为0.79 g/L,治疗后为0.91 g/L,恢复到正常参考值范围(0.88 ～ 2.01 g/L).结论 慢性布病患者采用提高免疫力措施能提高临床治疗效果.

abstractsObjective To investigate the effect of improving immunity in the treatment of chronic brucellosis,and to analyze and evaluate its clinical curative effect.Methods A patient with chronic brucellosis was treated with Mongolian medicine combined with chemical drugs to enhance immunity.The clinical symptoms,serological antibodies,Brucella DNA and immune function were compared before and after treatment.The specific antibody against Brucella in serum was detected by tube agglutination test (SAT) and tiger red plate agglutination test (RBPT).Brucella DNA in serum and blood cells was detected by PCR,and the peripheral blood lymphocyte subsets were detected by flow cytometry.Immuno-luminescence technique was used to detect serum immunoglobulin and complement components.Results After treatment,the clinical symptoms such as cold back,fatigue,and joint pain disappeared completely,and the results of serum specific antibodies against Brucella were SAT 1 ∶ 50 (++)and RBPT (+) with no changes before and after treatment,and the results of cells and serum were both negative after treatment though the results of DNA detection of Brucella were cell positive and seronegative before treatment.The results of immunological function test showed that γδT cells decreased to 9.50％ after treatment compared to 14.00％ before treatment,and the percentage of monocytes and Treg cells were 5.59％ and 7.33％ after treatment,which were higher than 3.35％ and 4.72％ of before treatment,and the level of complement C3 was 0.79 g/L before treatment and 0.91 g/L after treatment that was returned to normal reference range (0.88 ～ 2.01 g/L).Conclusion The patients with chronic brucellosis can improve their clinical treatment by improving immunity.