胸腺肽α_1对小儿重症肺炎肿瘤坏死因子及白细胞介素-6的影响

Effect of Thymosin α_1 on Tumor Necrosis Factor and Interleukin-6 in Children with Severe Pneumonia

目的:探讨胸腺肽α1对小儿重症肺炎肿瘤坏死因子及白细胞介素-6的影响。方法:选择2012年7月—2014年10月在妇幼保健院儿科接受治疗的重症肺炎患儿86例作为研究对象,86例重症肺炎患儿随机分成对照组和观察组两组,各43例。对照组患者接受重症肺炎的常规药物治疗。观察组在对照组治疗的基础上同时皮下注射胸腺肽α1。结果:观察组重症肺炎患儿的总有效率为95.35%高于对照组重症肺炎患儿的总有效率79.07%,差异具有统计学意义(χ2=5.108,P<0.05)。治疗后,观察组患儿的m HLA-DR水平(46.2±8.5)%高于对照组患儿的m HLA-DR水平(33.1%±3.5%,且观察组患儿IL-6水平(44.6±11.3)ng·L-1、TNF-α水平(42.4±11.7)ng·L-1低于对照组患儿的IL-6水平(67.1±22.5)ng·L-1、TNF-α水平(63.2±21.1)ng·L-1,差异具有统计学意义(P<0.01)。治疗后,观察组患儿CD3+水平(55.2±9.6)%、CD4+水平(53.4±9.9)%、CD4+/CD8+水平(2.5±1.2)%高于对照组患儿的CD3+水平(44.8±9.1)%、CD4+水平(42.5±9.5)%、CD4+/CD8+水平(1.7±0.8)%,且观察组患儿CD8+水平(24.6±3.1)%低于对照组患儿CD4+/CD8+水平(33.7±4.2)%,差异具有统计学意义(P<0.01)。治疗后,观察组患儿的MMF水平(1.72±0.29)L/s、PEF水平(2.14±0.28)L/s、PImax水平(83.41±8.23)%及PEmax水平(47.81±6.16)%高于对照组患儿的MMF水平(1.16±0.24)L/s、PEF水平(1.48±0.27)L/s、PImax水平(73.93±7.44)%及PEmax水平(39.23±5.76)%,差异具有统计学意义(P<0.01)。结论:胸腺肽α1治疗小儿重症肺炎能够减轻患儿局部炎症反应、提高免疫功能、改善肺功能,进而增强治疗效果。

Objective： To explore the effect of Thymosin α1 on the tumor necrosis factor and interleukin-6 in children with severe pneumonia. Methods： 86 children with severe pneumonia who had received treatment in maternal and child health hospital between July 2012 and October 2014 were selected as the research object, which were randomly divided into control group and observation group, each with 43 cases. Patients in the control group were given conventional drug treatment, whereas those in the observation group were given subcutaneous injection of Thymosin α1 based on the conventional treatment given to the control group. Results： The total effective rate in the observation group was 95.35%, higher than that in the control group, which was 79.07%, and the difference was statistically significant（χ2=5.108, P 0.05）. After treatment, the level of m HLA-DR in the observation group was（46.2±8.5）%, significantly higher than that in the control group, which was（33.1±3.5）%. Moreover, the levels of IL-6 and TNF-α in the observation group were respectively（44.6±11.3） ng·L-1 and（42.4±11.7）ng·L-1, both lower than those in the control group, which were respectively（67.1±22.5）ng·L-1 and（63.2±21.1）ng·L-1. All of the differences were statistically significant（P〈0.01）. After treatment, the levels of CD3＋, CD4＋ and CD4＋/CD8＋ in the observation group were respectively（55.2±9.6）%,（53.4±9.9）% and（2.5±1.2）%, all significantly higher than those in the control group, which were respectively（44.8±9.1）%,（42.5±9.5）% and（1.7±0.8）%, and the differences were statistically significant（P〈0.01）. After treatment, the levels of MMF, PEF, PImax and PEmax in the observation group were respectively（1.72±0.29）L/s,（2.14±0.28） L/s,（83.41±8.23）% and（47.81±6.16）%, all higher than those in the control group, which were respectively（1.16±0.24）L/s,（1.48±0.27） L/s,（73.93±7.44）% and（39.23±5.76）%; all with statistically significant differences（P〈0.01）. Conclusion： In the treatment of children severe pneumonia, Thymosin α1 can reduce the incidence of local inflammation, and improve the immune and lung function, and the therapeutic effects.