胸腺五肽对老年慢性阻塞性肺疾病患者血清白细胞介素17A、趋化因子12水平及瞬时受体电位通道1表达的影响

Effect of thymopentin combined with conventional therapy on serum IL-17A, CXCL12 levels and TRPC1 expression in elderly patients with chronic obstructive pulmonary disease

目的 探讨胸腺五肽联合常规药物对老年COPD患者血清白细胞介素17A（IL-17A）、趋化因子12 （CXCL12）水平及瞬时受体电位通道1（TRPC1）表达的影响.方法 选择156例COPD患者为研究对象,按照随机数字表法分为两组（n=78）.对照组进行常规治疗;观察组在常规治疗的基础上进行胸腺五肽皮下注射.测定治疗前后CD3＋、CD4＋、CD8＋、CD4＋/CD8＋水平以比较两组免疫功能,治疗前后测定1秒用力呼气容积（FEV1）、残气量/肺总量比率（FEV1/FVC）及最大呼气流量（PEF）以比较两组肺通气功能,测定和比较两组患者治疗前后外周血IL-17A、CXCL12水平及肺泡灌洗液中TRPC1水平.比较两组患者的不良反应.结果 治疗前,两组CD3＋、CD4＋、CD8＋及CD4＋/CD8＋差异均无统计学意义（均P＞0.05）;治疗后,对照组未发生显著变化（P＞0.05）,观察组CD3＋、CD4＋、CD4＋/CD8＋[（65.17±2.39）％、（41.06 ±2.15）％、（1.50±0.74）％]显著高于对照组[（52.66±2.38）％、（32.30±2.05）％、（0.80±0.81）％],CD8＋ （24.02±2.23）％显著低于对照组[（32.66±1.97）％,P＜0.05].治疗前,两组患者FEV1、FEV1/FVC、PEF均无显著差异（均P＞0.05）;治疗后两组患者的FEV1、FEV1/FVC、PEF均显著升高（均P＜0.05）,且观察组均显著高于对照组（均P＜0.05）.治疗前两组患者外周血IL-17A、CXCL12水平及肺泡灌洗液中TRPC1水平差异均无统计学意义（均P＞0.05）;治疗后,观察组患者外周血IL-17A[（24.18±3.69） pg/mL]、CXCL12水平[（193.50 ±2.90） pg/mL]及BALF中TRPC1水平[（7.69±1.14）ng/L]显著降低（P＜0.05）,对照组患者外周血IL-17A[（34.25±3.74） pg/mL]、CXCL12水平[（205.37±3.21） pg/mL]及BALF中TRPC1水平[（14.25±1.20） ng/L]也显著降低（P＜0.05）,且观察组显著低于对照组（P＜0.05）.观察组和对照组的不良反应的总发生率为16.67％、12.82％,差异无统计学意义（P＞0.05）.结论 胸腺五肽联合常规药物治疗能显著提高老年COPD患者的免疫功能,改善肺通气功能,降低炎症因子,缓解炎症反应,安全有效.

Objective To investigate the effect of thymopentin combined with routine medication on serum interleukin 17A（IL-17A）,chemokine 12 （CXCL12） levels and transient receptor potential channel 1 （TRPC1）expression in elderly patients with chronic obstructive pulmonary disease （COPD）.Methods 156 COPD patients were selected as study objects.They were randomly divided into two groups（n =78） according to the digital table.The control group received routine treatment,and the observation group received subcutaneous injection of thymopentin on the basis of routine treatment.Before and after treatment,the CD3＋,CD4＋,CD8＋,CD4＋/CD8＋ levels were tested to compare the immunologic function of the two groups.Before and after treatment,the FEV1,FEV1/FVC,PEF were tested to compare the pulmonary ventilation function of the two groups.The IL-17A,CXCL12 levels in peripheral blood and TRPC1 level in bronchoalveolar liquid before and after treatment were tested and compared between the two groups.The adverse effect was compared.Results Before treatment,the CD3＋,CD4＋,CD8＋ and CD4＋/CD8＋ between the two groups had not statistically significant differences （all P 〉 0.05）,which of the control group after treatment had no significant change （all P 〉 0.05）,the CD3＋,CD4＋,CD4＋/CD8＋ of the observation group [（65.17 ± 2.39） %,（41.06 ±2.15） %,（1.50 ± 0.74） %] were significantly higher than control group [（52.66 ± 2.38） %,（32.30 ± 2.05） %,（0.80 ± 0.81） %] （all P 〈 0.05）,and the CDs＋ of the observation group [（24.02 ± 2.23） %] was significantly lower than control group[（32.66 ± 1.97） %,P 〈0.05].Before treatment,the FEV1,FEV1/FVC,PEF,the IL-17A,CXCL12 levels and TRPC1 level had no statistically significant differences between the two groups（P 〉 0.05）.After treatment,the peripheral blood IL-17A [（24.18 ± 3.69） pg/mL],CXCL12 levels [（193.50 ± 2.90） pg/mL] and TRPC1 level in BALF [（7.69 ± 1.14）ng/L] in the observation group decreased significantly（P 〈 0.05）,which in the control group also decreased significantly [IL-17A （34.25 ± 3.74） pg/mL,CXCL12 （205.37 ± 3.21） pg/mL,TRPC1 （14.25 ± 1.20）ng/L] （P 〈 0.05）,which of the observation group were significantly lower than those of the control group（all P 〈0.05）.The incidence rates of adverse effects of the two groups were t6.67%,12.82%,there was no statistically significant difference（P 〉 0.05）.Conclusion Thymopentin combined with conventional therapy can effectively improve the elderly COPD patients＇immunologic function and pulmonary ventilation function,decrease the inflammatory factor,relieve inflammatory reaction and it is safe and effective.