常规治疗联合胸腺肽-α1对慢性阻塞性肺疾病急性加重期合并肺结核患者临床疗效及免疫功能的影响

Clinical Efficacy and Effects on Immune Function of Conventional Therapy Combined with Thymosin-α1 Therapy in the Treatment of Acute Exacerbation of Chronic Obstructive Pulmonary Disease Combined with Pulmonary Tuberculosis

目的:探讨常规治疗联合胸腺肽-α1对慢性阻塞性肺疾病急性加重期(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)合并肺结核患者临床疗效及免疫功能的影响。方法:选择2015年2月~2018年3月在本院接受治疗的AECOPD合并肺结核患者82例进行研究。采用随机数字表法将患者分为对照组和观察组,每组各41例。对照组行常规治疗;观察组在对照组基础上加以胸腺肽-α1治疗。比较两组患者临床疗效、免疫功能、炎症因子、痰菌转阴率及不良反应。结果:观察组患者总有效率为90.24%,高于对照组的73.17%(P<0.05)。治疗后两组患者CD4+及CD4+/CD8+均明显升高,两组CD8+均明显下降,但观察组患者升高或下降较为显著(P<0.05)。治疗后两组患者IL-6、TNF-α及IFN-γ水平均明显下降,但观察组患者下降较为显著(P<0.05)。观察组患者治疗后3个月、6个月痰菌转阴率分别为78.05%及87.80%,均明显高于对照组的56.10%及68.29%(P<0.05)。对照组共出现7例(17.07%)不良反应,观察组出现9例(21.95%),两组比较差异无统计学意义(P>0.05)。结论:常规治疗联合胸腺肽-α1较单独使用胸腺肽-α1可明显提高AECOPD合并肺结核患者临床疗效,改善患者免疫功能、缓解炎症反应,提高痰菌转阴率且具有较高的安全性。

Objective:To explore the effect of conventional treatment combined with thymosin-α1 treatment on the clinical efficacy and immune function of patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD)and pulmonary tuberculosis.Methods:A total of 82 patients with AECOPD combined with tuberculosis who were treated in our hospital from February 2015 to March 2018 were selected for the study.Random number table method was used to divide patients into 2 groups,41 cases in each group.The control group was treated with routine treatment,while the observation group with additional thymosin-α1 treatment on that basis.The clinical efficacy,immune function,inflammatory factors,sputum bacteria conversion rate and adverse reactions were compared between the two groups.Results:The total effective rate of the observation group was 90.24%,higher than 73.17%of the control group(P<0.05).After treatment,the CD4+and CD4+/CD8+of the two groups of patients were significantly increased,and the CD8+of the two groups were significantly decreased,with more changes found in the observation group(P<0.05).In the observation group,the sputum bacterial conversion rate was 78.05%and 87.80%at 3 and 6 months of treatment,which were significantly higher than the control group of 56.10%and 68.29%respectively(P<0.05).There were 7 cases(17.07%)of adverse reactions in the control group and 9 cases(21.95%)in the observation group,which was not statistically significant different(P>0.05).Conclusion:Routine treatment combined with thymosin-α1 treatment can significantly improve the clinical efficacy of AECOPD patients with pulmonary tuberculosis compared with thymosin-α1 treatment alone,improve the patient's immune function,relieve inflammation,increase the rate of sputum bacteria turning negative,and with higher safety.