免疫治疗对重症肺炎患者免疫功能指标及炎症因子的影响

Effects of immunotherapy on immune function and inflammatory factors in patients with severe pneumonia

目的研究免疫制剂胸腺肽α1与人免疫球蛋白治疗重症肺炎的临床效果,并探讨其对患者免疫功能指标及炎症因子的影响。方法选择2015年1月至2016年5月该院收治的重症肺炎患者106例,将其分为研究组与对照组,每组53例,两组均采用常规法治疗。对照组加用免疫制剂胸腺肽α1治疗,研究组则在对照组的基础上加用人免疫球蛋白治疗,比较分析两组的临床疗效、不良反应,治疗前后T细胞亚群、IgA、IgG及IgM等免疫功能指标和血清TNF-α、IL-6和IL-8等炎症因子变化。结果研究组治疗总有效率为98.1%,明显高于对照组治疗总有效率77.4%(P<0.05)。治疗前,两组血清CD4+、CD8+、CD4+/CD8+比较,差异无统计学意义(P>0.05);治疗后,研究组血清CD4+、CD4+/CD8+明显高于对照组,CD8+明显低于对照组(P<0.05)。治疗前,两组血清IgA、IgG、IgM、TNF-α、IL-6和IL-8水平比较差异无统计学意义(P>0.05);治疗后,研究组血清IgA、IgG及IgM免疫指标水平均明显高于对照组(P<0.05)。研究组TNF-α、IL-6和IL-8水平均明显低于对照组低(P<0.05)。两组患者在治疗期间均未出现死亡,也无1例出现明显与药物相关的不良反应。结论免疫制剂胸腺肽α1与人免疫球蛋白治疗重症肺炎患者效果显著,可以有效改善患者T细胞群,提高患者免疫功能,降低血清炎症因子水平,不良反应少,临床上值得应用。

Objective To study the clinical effect of immune preparation thymosinα1and human immunoglobulin for the treatment of severe pneumonia,and explore its effect on the immune function and inflammatory factors in patients.Methods 106 cases of severe pneumonia in hospital from January 2015 to May 2016 were selected and randomly divided into study group and control group,53 cases each group,and the two groups were treated with conventional therapy.The control group was treated with immune preparation thymosinα1,and the study group was treated with human immunoglobulin on the basis of the treatment of the control group.The clinical efficacy and adverse reactions between the two groups,the changes of T cell subsets,IgA,IgG,IgM and other immune function indicators and serum TNF-α,IL-6,IL-8and other inflammatory factors before and after treatment were compared and analyzed.Results The total effective rate of the study group was 98.1%,which was significantly higher than that of the control group,and the total effective rate of the control group was 77.4%（P0.05）.Before treatment,the serum CD4＋,CD8＋,and CD4＋/CD8＋of the two groups were no significant differences（P0.05）;after treatment,the serum CD4＋and CD4＋/CD8＋of study group were significantly higher than those of the control group,and the CD8＋was significantly lower than that of the control group（P0.05）.Before treatment,the serum IgA,IgG,IgM,TNF-α,IL-6and IL-8level of the two groups were no significant differences（P0.05）;after treatment,the serum IgA,IgG and IgM immune index level of the study group were significantly better than those of the control group（P0.05）.The TNF-α,IL-6and IL-8level of the study group were significantly lower than those of the control group（P0.05）.The patients of two groups were not dead in the treatment period,and no obvious drug-related adverse reactions occurred in 1cases.Conclusion The therapeutic effect of immune preparation thymosinα1and human immunoglobulin on the patients with severe pneumonia is significant,they can effectively improve the T cells of patients,enhance the immune function,reduce serum levels of inflammatory factors,and the adverse reactions is less,clinical application is worthy.