胸腺法新联合抗生素用于恶性肿瘤并发肺部感染的疗效观察

Therapeutic efficacy of thymalfasin combined with antibiotics on malignant tumors complicated with pulmonary infection

目的探讨胸腺法新联合抗生素用于恶性肿瘤并发肺部感染的疗效。方法选取2016年8月至2018年8月间四川省成都市第五人民医院收治的60例恶性肿瘤并发肺部感染患者,其中,使用胸腺法新联合抗生素治疗的30例患者纳入联合治疗组,单独使用抗生素治疗的30例患者纳入单独治疗组。分析比较两组患者的临床疗效、临床肺部感染评分(CPIS)、T细胞亚群、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞计数(WBC)、体温恢复正常时间、咳嗽停止时间、肺部啰音消失时间、胸片检查、血象恢复正常时间和不良反应发生情况。结果联合治疗组患者治疗的总有效率90. 0%,显著高于单独治疗组患者的63. 3%,差异有统计学意义(P <0. 05)。治疗前,两组患者的CPIS评分比较,差异无统计学意义(P> 0. 05)。治疗后,两组患者CPIS评分均显著降低,且和单独治疗组相比,联合治疗组患者的CPIS评分较低,差异有统计学意义(P <0. 05)。治疗前,两组患者的CD3+、CD4+、CD8+和CD4+/CD8+比较,差异无统计学意义(P>0. 05)。治疗后,两组患者的CD3+、CD4+、CD8+和CD4+/CD8+均显著升高,且和单独治疗组相比,联合治疗组患者的CD3+、CD4+、CD8+和CD4+/CD8+均较高,差异均有统计学意义(均P <0. 05)。治疗前,两组患者CRP、TNF-α、IL-6和WBC比较,差异无统计学意义(P> 0. 05)。治疗后,两组患者的CRP、TNF-α、IL-6和WBC均显著降低,且和单独治疗组相比,联合治疗组患者的CRP、TNF-α、IL-6和WBC均显著降低,差异均有统计学意义(均P <0. 05)。联合治疗组患者的体温恢复正常时间、咳嗽停止时间、肺部啰音消失时间、胸片检查、血象恢复正常时间均显著短于单独治疗组患者,差异均有统计学意义(均P <0. 05)。两组患者的不良反应发生率比较,差异无统计学意义(P> 0. 05)。结论胸腺法新联合抗生素用于恶性肿瘤并发肺部感染的疗效较单独抗生素显著,值得在临床推广应用。

Objective To investigate the efficacy of thymus thymalfasin combined with antibiotics in the treatment of malignant tumors complicated with pulmonary infection.Methods From August 2016 to August 2018,60 patients with malignant tumors complicated with pulmonary infection at Fifth People’s Hospital of Chengdu were selected and randomly divided into a combination therapy group and a single treatment group according to random table method.The combination therapy group was treated with thymalfasin combined with antibiotics and the single treatment group was treated with antibiotics alone with 30 patients in each group.Then the clinical efficacy,clinical pulmonary infection score(CPIS)score,T cell subsets,Creactive protein(CRP),tumor necrosis factorα(TNF-a),interleukin-6(IL-6),white blood cell(WBC),body temperature rested time,time to cough relief,time to disappearance of crackles in the lung rale,chest X-ray examination,blood picture recovery time and adverse reactions were statistically analyzed.Results The overall efficacy rate was 90.0%in the combination therapy group which was significantly higher than 63.3%of the single treatment group(P<0.05).After the treatment,CPIS score decreased in both groups and compared with the single treatment group,the CPIS score was significantly lower in the combination therapy group(all P<0.05),but there was no significant difference between the two groups before treatment(P>0.05).There were no significant differences in CD3+,CD4+,CD8+,CD4+/CD8+between the two groups before the treatment(P>0.05).However,after the treatment,CD3+,CD4+,CD8+,CD4+/CD8+increased in both groups and the levels were significantly higher in the combination therapy group than those in the single treatment group(all P<0.05).There were no significant differences in CRP,TNF-a,IL-6 and WBC between the two groups before treatment(P>0.05).However,after the treatment,CRP,TNF-a,IL-6 and WBC decreased in both groups with and above levels were significantly lower in the combination therapy group than in the single treatment group(all P<0.05).The time of rested body temperature,cough relief time,lung crackles disappearance time,chest X-ray examination and blood picture were significantly shorter in the combination therapy group than in the single treatment group(all P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion The treatment efficacy of thymalfasin combined with antibiotics for malignant tumors complicated with pulmonary infection is better than single antibiotics,and the former is worthy of clinical application.