利奈唑胺注射液联合胸腺肽治疗重症肺炎的疗效及作用机制

Efficacy and mechanism of linezolid injection combined with thymosin in treatment of severe pneumonia

目的:观察利奈唑胺注射液联合胸腺肽治疗重症肺炎的疗效以及对T淋巴细胞亚群CD4^+/CD8^+和免疫球蛋白IgA、IgM与IgG的影响。方法:本组研究病例共80例,按数字表法随机分为治疗组和对照组,两组各40例;所有患者均给予吸氧、补液、化痰以及营养支持等常规治疗。对照组采取利奈唑胺注射液静脉滴注治疗,1次/12 h,600 mg/次;治疗组在对照组基础上给予胸腺肽粉针治疗,100 mg/次,采取500 m L 5%葡萄糖注射液稀释静脉滴注,1次/d;所有患者均连续治疗2周。比较两组治疗前后APACHEⅡ评分及动脉血气变化;分析两组治疗2周后的临床疗效;检测两组治疗前后T淋巴细胞亚群CD4^+/CD8^+以及IgA、IgM与IgG变化。结果:治疗组总有效率为92.5%,对照组为72.5%,治疗组优于对照组(χ2=4.242,P<0.05);治疗组治疗后患者APACHEⅡ评分和Pa CO2均显著低于对照组,而Pa O2和Sa O2均显著高于对照组(P<0.01);治疗组治疗后患者T淋巴细胞亚群CD4^+/CD8^+和IgA、IgM和IgG均高于对照组治疗后,比较差异有统计学意义(P<0.01)。结论:利奈唑胺注射液联合胸腺肽治疗重症肺炎可改善患者动脉血气水平,提高APACHEⅡ评分,提高临床治疗效果,提高T淋巴细胞亚群CD4^+/CD8^+和IgA、IgM与IgG水平可能是其发挥治疗作用的机制之一。

Objective: To observe curative effect of linezolid injection combined with thymosin in treatment of severe pneumoniaand its influences on levels of T lymphocyte subsets CD4 +/CD8 + ,IgA,IgM and IgG. Methods:Eighty severe pneumonia patients wererandomly divided into treatment group and control group of 40 cases each according to randomized digital table. All patients were givenroutine medical treatment of oxygen, infusions, dissipating phlegm and nutrition support. The control group were added intravenous linezolidinjection( ql2h ,600 mg/time) . On the basis of the control treatment, the treatment one received thymosin (100 mg/time, qd)with 500 mL 5 % glucose for diluting intravenous drip. Courses of treatment for two groups were two weeks. The changes of arterialblood gas and scores of APACHE II were compared pre-post treatment to evaluate curative effects in both groups. Levels of T lymphocytesubsets CD4 + /C D 8 + ,IgA,IgM and IgG pre-post treatment were detected in two groups. Results:The total effective rate for treatmentgroup was 92. 5% ,better than control group with 72. 5% (^2 = 4. 242 ,P < 0. 0 5 ). PaC02 and APACHE II in treatment group wereobviously lower than those of control one, while Sa02 and Pa02 were obviously higher than those of control one after treatment (P <0. 0 1 ). Levels of T lymphocyte subsets CD4 + /CD8 + ,IgA,IgM and IgG in treatment group were obviously higher than those of controlgroup with significant differences after treatment(P < 0. 0 1 ). Conclusion: Linezolid injection combined with thymosin in treatment ofsevere pneumonia could improve APACHE II scores, arterial blood gas and curative effect. Increasing levels of T lymphocyte subsetsCD4 + /C D 8 + ,IgA,IgM and IgG may be one of its mechanism.