胸腺法新对老年SCAP患者血清免疫蛋白及T淋巴细胞亚群的影响及疗效分析

Effect of Thymosin-α1 on level of serum immunoglobulin and T lymphocyte subsets in aged patients with severe community-acquired pneumonia

目的:探讨注射用胸腺法新治疗老年社区获得性重症肺炎(SCAP)的疗效以及对患者体内血清免疫蛋白及T淋巴细胞亚群水平的影响。方法:将142例老年SCAP患者根据治疗方法不同分为常规治疗组和胸腺法新治疗组,每组各71例。常规治疗组给予抗感染等对症支持治疗,同时经口气管插管接呼吸机辅助通气;胸腺法新治疗组在常规治疗基础上皮下注射胸腺法新,比较两组治疗前后血清免疫蛋白及T淋巴细胞亚群水平的变化,比较两组生存情况。结果:治疗后1周胸腺法新治疗组总有效率为61.97%,显著高于常规治疗组(47.89%,χ2=7.15,P=0.026),治疗后30d内累积生存率为57.9%,显著高于常规治疗(33.2%,χ2=10.86,P=0.013);治疗1周后胸腺法新治疗组CD4+水平和CD4+/CD8+比值显著高于治疗前和常规治疗组治疗后水平,而CD8+水平显著低于治疗前和常规治疗组治疗后水平(P<0.05);两组组治疗1周后IgA、IgG、IgM及补体C3、C4免疫球蛋白间差异无统计学意义(P>0.05)。结论:注射用胸腺法新能显著提高常规对症支持治疗老年社区获得性重症肺炎患者累积生存率,其作用机制可能与胸腺法新促进胸腺内的骨髓干细胞刺激CD4+淋巴细胞产生有关。

Objective： To investigate effect of Thymosin-α1 on level of serum immunoglobulin and T lymphocyte subsets in aged patients with severe community-acquired pneumonia （SCAP）. Methods： A total of 142 elderly patients with SCAP were divided into the routine treatment groups and the Thymosin treatment groups according to the different treatment methods by half. Patients in the routine treatment groups were given with anti infection and symptomatic and supportive treatment, orotra- cheal intubation ventilator assisted ventilation. Patients in Thymosin treatment groups given with Thymosin-cd injection based on the routine treatment groups. The level of serum immunoglobulin and T lymphocyte subsets before and after treatment and survival of two groups were compared. Results： The total effectiveness in the Thymosin treatment groups after 1 weeks were 61.97%, significantly higher than that of the conventional treatment groups 47.89% （χ^2= 7.15, P = 0.026） and the cumulative survival rate within 30 d after treatment was 57.9% significantly higher than that of the conventional treatment groups 33.2% （χ^2 =10.86, P=0. 013）. The levels of CD4^＋ level and the CD4^＋/CD8^＋ ratio in the Thymosin treatment groups were sig- nificantly higher than those of before treatment and the routine treatment groups after treatment while the level of CD8^＋ were significantly lower than that of before treatment and the routine treatment groups after treatment （P〈0.05）. There was no significant difference in level of IgA, IgG, IgM and complement C3, C4 immunoglobulin between the two groups after 1 weeks of treatment （P〉0.05）. Conclusions： Thymosin-al could significantly improve the cumulative survival rate of elderly patients with SCAP.It may be because that thymalfasin promote intrathymie bone marrow stem cells, then stimulate CD4^＋ lymphocyte to produce the relevant.