胸腺肽治疗重症肺炎合并脓毒血症的临床研究

Clinical Study of Thymosin in the Treatment of Severe Pneumonia Combined with Sepsis

目的探讨胸腺肽治疗重症肺炎合并脓毒血症的临床治疗效果。方法方便选择2015年2月—2017年10月72例重症肺炎合并脓毒血症患者,运用随机数字表法将其分为对照组(n=36)与实验组(n=36),对照组施以常规治疗,实验组施以皮下注射胸腺肽治疗,观察两组患者治疗后各项转归时间、治疗前后呼吸频率、心率、白细胞计数及血浆降钙素原含量水平变化与治疗前后IL-6、TNF-α、T淋巴细胞亚群的变化情况。结果治疗前,两组患者的各项指标含量无显著差异无统计学意义(P>0.05);治疗后,实验组的血管活性药停用时间、休克逆转时间与机械通气停用时间分别为(3.18±1.49)d、(80.75±30.14)h与(84.35±22.61)h,明显短于对照组的(6.37±1.96)d、(125.54±54.62)h与(143.28±50.46)h(t=7.774,4.308,6.395,P=0.000,0.0001,0.000);其呼吸频率与心率分别为(17.64±1.47)次/min与(72.05±10.28)次/min,明显低于对照组的(20.36±2.25)次/min与(81.63±10.17)次/min,(t=6.072,3.975,P=0.000,0.002);白细胞计数及血浆降钙素原含量水平分别为(7.31±3.27)×109/L与(1.06±0.07)ng/L,明显少于对照组的(9.74±3.42)×109/L与(1.85±0.23)ng/L(t=3.081,19.716,P=0.003,0.000);并且各项细胞炎性因子含量明显低于对照组,差异具有统计学意义(P<0.05)。结论胸腺肽治疗重症肺炎合并脓毒血症具有良好的临床效果,能够在较大程度上改善患者的临床症状,具有较高的临床推广价值。

Objective This paper tries to investigate the clinical efficacy of thymosin in the treatment of severe pneumonia and sepsis. Methods From February 2015 to October 2017, 72 patients with severe pneumonia combined with sepsis were convenient selected and randomized into the control group（n =36） and experimental group（n =36）. The control group was treated with routine treatment, the experimental group was treated with subcutaneous thymosin injection. The changes of the outcome time, pre-and post-treatment respiratory frequency, heart rate, white blood cell count, and plasma procalcitonin levels before and after treatment were observed in the experimental group. IL-6 and TNF were measured before and after treatment.-Changes in α, T lymphocyte subsets. Results Before treatment, there was no significant difference in the content of each index between the two groups of patients（P〉0.05）. After treatment, the duration of vasoactive drug withdrawal,shock reversal, and mechanical ventilation deactivation were respectively（3.18±1.49）d,（80.75±30.14）h and（84.35±22.61）h,significantly shorter than（6.37 ±1.96）d,（125.54 ±54.62）h and（143.28 ±50.46）h（t =7.774, 4.308, 6.395, P =0.000,0.0001,0.000）; their respiratory frequency and heart rate were（17.64±1.47） beats/min and（72.05±10.28） beats/min, respectively, significantly lower than those of the control group（ 20. 36 ± 2. 25） times/min and（ 81. 63 ± 10. 17） times/min（ t =6.072,3.975,P=0.000,0.002）; white blood cell count and plasma procalcitonin levels were（7.31±3.27）×10^9/L, respectively.And（1.06±0.07）ng/L, significantly less than the control group（9.74±3.42）×10^9/L and（1.85±0.23）ng/L,（t=3.081,19.716,P=0.003,0.000）; and the content of inflammatory cytokines in various cells was significantly lower than that in the control group, and the difference was statistically significant（P〈0.05）. Conclusion Thymosin treatment of severe pneumonia combined with sepsis has a good clinical effect, can greatly improve the patient＇s clinical symptoms, has a high value of clinical promotion.