胸腺肽α1对高龄老年细菌性肺炎的影响

Effects of Thymosin α1 on Elderly Patients with Bacterial Pneumonia

目的探讨胸腺肽α1（TM）在高龄老年人细菌性肺炎免疫调节治疗过程中血清降钙素原（PCT）与外周血T淋巴细胞亚群的表达变化。方法收集≥80岁高龄老年人细菌性肺炎患者58例，随机分为观察组（A1组）与对照组（A2组）各29例。A1组于入院后当天给予基础治疗＋胸腺肽α1（Tcd）注射液1．6mg，皮下注射，隔日一次，疗程2周；A2组仅给予基础治疗2周。两组于住院后第1d及第14d分别检测患者PCT和外周血T淋巴细胞亚群（CD3＋、CD4＋、CD8＋、CD3＋／CD8＋）水平，观察比较各组的临床疗效。结果两组患者治疗后PCR较治疗前均降低，A1组降低较A2组更明显，差异有统计学意义（P〈0．05）。A1组较A2组治疗后CD3＋、CD4＋、CD4＋／CD8＋免疫指标改善显著，相比结果有统计学意义（P〈0．05）。结论Ted辅助治疗可有效调节增强高龄老年细菌性肺炎患者机体免疫功能，降低炎症反应，改善预后。PCT与外周血T淋巴细胞亚群的表达与高龄老年人细菌性肺炎有关，是高龄老年人肺部感染诊治的检测指标之一。

Objective To explore expressions of serum procalcitonin （PCT）and peripheral blood T lymphocyte subsets in aged patients with bacterial pneumonia undergoing immune regulation therapy with thymosin α1. Methods 58 elderly patients（ ≥ 80 years）with bacterial pneumonia were randomly divided into observation group （A1 group） and control group（A2 group）with 29 patients in each group. Basic treatment plus thymosin α1 injection of 1.6 mg （subcutaneous injection, once every second day,2 weeks as a course）was given to patients in A1 group. Basic treatment was given to patients in A2 group for 2 weeks. PCT and levels of peripheral blood T lymphocyte subsets（ CD3＋ , CD4＋ , CD8＋ , CD4＋/CD8 ＋ ）were measured 1 d and 14 d after admission to hospital. Clinical effects were compared between the two groups. Results PCR decreased after treatment in both groups and A1 group decreased more significant than A2 group（P 〈 0.05 ）. CD3 ＋ , CD4＋ and CD4＋/CD8＋ improved significantly in A1 groups than those in A2 group （P 〈 0.05）. Conclusion Thymosin α1 can regulate immune function effectively in elderly patients with bacterial pneumonia. It can alleviate inflammation and improve prognosis. PCT and expressions of peripheral blood T lymphocyte subsets have correlation with elderly patients with bacterial pneumonia, which is one of the important measurements in diagnosis and treatment of elderly patients with bacterial pneumonia.