胸腺肽α_1治疗老年慢性阻塞性肺疾病合并侵袭性肺真霉菌病的临床效果

Clinical effect of thymosin α1 in treatment of senile COPD patients with invasive pulmonary aspergillosis

目的观察伏立康唑与胸腺肽α_1联合治疗老年慢性阻塞性肺疾病(慢阻肺)合并侵袭性肺真菌病(IFD)的临床效果。方法选择73例慢阻肺合并IFD患者作为研究对象,所有患者均给予辅助通气、抗感染、化痰、解除气道痉挛等常规治疗,采用分层随机分组法将其随机分为两组,对照组(n=36)采用伏立康唑序贯治疗,观察组(n=37)在对照组基础上加用胸腺肽α_1治疗;评价两组患者的临床疗效,观察两组患者治疗前后的T淋巴细胞表型及细胞因子变化情况,统计两组患者治疗期间的不良反应。结果观察组的总有效率高于对照组(P<0.05);对照组治疗前、后的CD_4^+比例、CD_4^+/CD_8^+比值、IFN-γ、IL-12变化无统计学意义(P均>0.05),观察组治疗前、后的CD_4^+比例、CD_4^+/CD_8^+比值、IFN-γ、IL-12变化有统计学意义(P均<0.05);两组不良反应发生率差异无统计学意义(P>0.05)。结论伏立康唑与胸腺肽α_1联合治疗老年慢阻肺合并侵袭性肺真菌病的临床效果显著,能够增强患者的自身免疫能力,利于预后的改善,且不增加患者用药不良反应,具有较高的临床应用价值。

Objective To observe the clinical effect of voriconazole and thymosin α1 in treatment of senile COPD patients with invasive pulmonary aspergillosis. Methods 73 COPD patients with IFD were selected as the research object,and all the patients were given assisted ventilation,anti-infection,phlegm,and airway relieving. They were randomly divided into two groups: the control group( n = 36) with voriconazole sequential therapy,and the observation group( n = 37) additionally treated with thymosin α1. The clinical efficacy was evaluated,and T lymphocyte phenotype changes and adverse reactions were observed in the two groups before and after the treatment. Results The total effective rate was higher in the observation group than in the control group( P < 0. 05). There was no significant difference in the proportion of CD4+,CD4+/CD8+ ratio,IFN-gamma,or IL-12 before and after treatment in the control group( P > 0. 05),but they showed significant difference in the observation group before and after treatment( P < 0. 05). The incidence of adverse reactions was similar between the two groups( P > 0. 05). Conclusion Voriconazole and thymosin α1 has significantly clinical effect in treatment of senile COPD patients with IFD,which can enhance the immune ability of patients,improve prognosis,and have high clinical value.