胸腺肽联合特布他林治疗慢性阻塞性肺疾病并发肺部感染的随机对照研究

Efficacy of thymosin plus terbutaline in treatment of patients with chronic obstructive pulmonary disease complicated with pulmonary infection:a randomized controlled study

目的探究胸腺肽联合特布他林对慢性阻塞性肺疾病并发肺部感染患者的疗效与基质金属蛋白酶-3(MMP-3)、白细胞介素-17(IL-17)、糖类抗原-125(CA125)水平的影响。方法选取2019年2月-2020年2月于海口市第四人民医院接受治疗的慢性阻塞性肺疾病并发肺部感染患者80例,根据数字分配法随机分为特布他林组、联合治疗组,每组患者各40例。特布他林组使用特布他林进行治疗,联合治疗组在特布他林基础上联合胸腺肽进行治疗。观察对比两组肺功能变化,采用酶联免疫吸附法对肿瘤坏死因子-α(TNF-α)、C-反应蛋白(CRP)、IL-17、伽马干扰素(IFN-γ)、糖类抗原-125(CA125)水平进行检测,免疫透射比浊法检测MMP-3水平,对比两组患者治疗效果及不良反应情况。结果治疗后,与特布他林组相比,联合治疗组用力肺活量(FVC)、第一秒用力呼气容积(FEV_1)、峰值呼气流速(PEF)水平升高(P<0.001);治疗后,患者血清TNF-α、CRP、IFN-γ水平降低,联合治疗组低于特布他林组(P<0.001);与特布他林组相比,治疗后,联合治疗组血清MMP-3、IL-17、CA125水平降低(P<0.001);联合治疗组疗效优于对照组(P=0.020);特布他林组不良反应发生率高于联合治疗组,但差异无统计学意义。结论采用胸腺肽联合特布他林对慢性阻塞性肺疾病并发肺部感染患者进行治疗,有效降低炎症反应发生,提高患者自身免疫能力,减轻肺部感染,治疗效果显著。

OBJECTIVE To investigate the efficacy of the combination of thymosin and terbutaline in patients with chronic obstructive pulmonary disease complicated with pulmonary infection and the effects on the levels of matrix metalloproteinase-3(MMP-3),interleukin-17(IL-17)and carbohydrate antigen-125(CA125).METHODS Eighty patients with chronic obstructive pulmonary infection treated in the Fourth People’s Hospital of Haikou from Feb.2019 to Feb.2020 were enrolled and randomly divided into the terbutaline group and combination therapy group by using the numerical allocation method,with 40 patients in each group.The terbutaline group was treated with terbutaline,and the combination therapy group was treated with terbutaline plus thymosin.The lung function change in the two groups were observed,and the levels of tumor necrosis factor-α(TNF-α),C-reactive protein(CRP),interleukin-17(IL-17),gamma interferon(IFN-γ)and carbohydrate antigen-125(CA125)were measured by enzyme-linked immunosorbent assay;the levels of matrix metalloproteinase-3(MMP-3)were measured by immune transmission turbidimetry.The treatment effect and adverse reactions were compared between the two groups.RESULTS After treatment,the levels of forced vital capacity(FVC),forced expiratory volume in one second(FEV1)and peak expiratory flow rate(PEF)in the combination therapy group significantly increased compared with the terbutaline group with(P<0.05).Serum levels of TNF-α,CRP,and IFN-γhad significant decrease in the patients of the combination therapy group compared with the terbutaline(P<0.05).The levels of serum MMP-3,IL-17,and CA125 were significantly decreased in the combination therapy group than that in the terbutaline group.The efficacy of combined treatment was better than that of terbutaline(P=0.020),and adverse effects were more frequent in the terbutaline group than that in the combination therapy group,although the differences were not significant.CONCLUSION Thymosin combined with terbutaline used to treat patients with COPD complicated with pulmonary infection can effectively reduce the occurrence of inflammatory reaction,improve the patients’autoimmune capacity and alleviate pulmonary infection,which shows obvious therapeutic effect.