重组人粒细胞刺激因子治疗重症肺炎的效果及对患者免疫功能的影响

Curative effect of recombinant human granulocyte colony-stimulating factor on severe pneumonia and its influences on immune function

目的探讨重组人粒细胞刺激因子(RHG-CSF)治疗重症肺炎的效果及对患者免疫功能的影响。方法选取2019年6月至2021年6月于本院确诊的88例重症肺炎患者作为研究对象,按照简单随机法分为观察组与对照组,每组44例。对照组采用亚胺培南西司他丁钠治疗,观察组在对照组基础上联合RHG-CSF治疗,比较两组临床疗效、治疗前后炎症因子[白细胞介素-6(IL-6)、白细胞介素-10(IL-10)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)]和免疫功能[T淋巴细胞亚群(CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))]及治疗期间不良反应发生情况。结果观察组治疗总有效率(90.92%)与对照组(77.27%)比较差异无统计学意义;治疗7 d后,两组IL-6、IL-10、TNF-α、CRP水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);治疗7 d后,两组CD8^(+)水平低于治疗前,CD4^(+)/CD8^(+)均高于治疗前,且观察组CD8^(+)水平低于对照组,CD3^(+)、CD4^(+)水平及CD4^(+)/CD8^(+)均高于对照组,差异有统计学意义(P<0.05);观察组不良反应发生率(6.82%)与对照组(20.45%)比较差异无统计学意义。结论RHG-CSF治疗重症肺炎患者的疗效显著,可增强患者免疫功能,降低炎症因子水平,且安全性高,值得临床推广应用。

Objective To explore the curative effect of recombinant human granulocyte colony-stimulating factor(RHG-CSF)on severe pneumonia and its influences on immune function.Methods A total of 88 patients with severe pneumonia confirmed in the hospital from June 2019 and June 2021 were enrolled as the research subjects,and they were divided into the observation group and the control group according to simple random method,with 44 cases in each group.The control group was treated with imipenem cilastatin sodium,while observation group was treated with RHG-CSF on basis of the control group,the clinical efficacy,inflammatory cytokines(interleukin-6[IL-6],interleukin-10[IL-10],tumor necrosis factor-α[TNF-α],C-reactive protein[CRP])and immune function(T lymphocyte subsets[CD4^(+),CD8^(+),CD4^(+)/CD8^(+)])before and after treatment and the incidence of adverse reactions during treatment were compared between the two groups.Results There was no significant difference in total clinical response rate between observation group(90.92%)and control group(77.27%).After 7 d of treatment,the levels of IL-6,IL-10,TNF-α,CRP in two groups were lower than before treatment,and the observation group was lower than control group,the differences were statistically significant(P<0.05).After 7 d of treatment,the levels of CD8^(+)of two groups were lower than before treatment,and the CD4^(+)/CD8^(+)of two groups were higher than before treatment,and the level of CD8^(+)in observation group was lower than that in the control group,and levels of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in observation group were higher than those in the control group,the difference was statistically significant(P<0.05).There was no significant difference in incidence of adverse reactions between observation group(6.82%)and control group(20.45%).Conclusion RHGCSF has significant efficacy in the treatment of severe pneumonia patients,can enhance the immune function of patients,reduce the level of inflammatory factors,and high safety,it is worthy of clinical promotion and application.