中华临床医师杂志（电子版）
中華臨床醫師雜誌（電子版）
중화림상의사잡지（전자판）
CHINESE JOURNAL OF CLINICIANS(ELECTRONIC VERSION)
2014年
6期
1026-1030
,共5页
赵晟珣%王桦%杨帆%王家瑜%葛亮%吴晓玲
趙晟珣%王樺%楊帆%王傢瑜%葛亮%吳曉玲
조성순%왕화%양범%왕가유%갈량%오효령
老年人%肺部感染%免疫调节%胸腺肽α1
老年人%肺部感染%免疫調節%胸腺肽α1
노년인%폐부감염%면역조절%흉선태α1
Aged%Lung infection%Immunoregulation%Thymosinα1
目的：观察了解高龄老年肺部感染患者细胞免疫与体液免疫功能变化，探讨胸腺肽α1（Tα1）免疫调节辅助抗感染治疗免疫功能改善的临床疗效。方法入选≥80岁高龄老年肺部感染患者68例，随机分为试验组（Tα1组）和对照组，每组各34例。Tα1组使用基础治疗（抗感染、袪痰、平喘、对症治疗）＋Tα1注射液1.6 mg，皮下注射，每日1次，2周为一个疗程。对照组34例仅使用基础治疗。两组治疗前后对比观察各项免疫指标：外周血 T 淋巴细胞亚群（CD3＋、CD4＋、CD8＋、CD4＋/CD8＋）；免疫球蛋白 IgG、IgA、IgM、IgE；补体 C3、C4水平和临床疗效评估。结果 T淋巴细胞表型变化比较，Tα1组治疗前CD3＋为（57.75±7.80）%、CD4＋为（33.43±5.27）%、CD4＋/CD8＋为1.41±0.46，均低于正常值，CD8＋[（30.02±5.60）%]高于正常值。治疗后 CD3＋为（66.89±9.84）%、CD4＋为（38.27±4.27）%、CD4＋/CD8＋为1.79±0.59，比治疗前均显著增高，CD8＋[（25.03±4.27）%]比治疗前下降，示免疫指标有所改善，相比结果有统计学意义（P＜0.05）。体液免疫指标变化比较：两组C3水平治疗前分别为（0.89±0.25）g/L、（0.86±0.37）g/L，较正常值均偏低，余体液免疫指标C4、IgG、IgA、IgE、IgM治疗前后相比无统计学差异（P＞0.05）。临床疗效观察总有效率Tα1组88.2%，高于对照组67.6%，两组比较有统计学差异（χ2＝8.171，P＜0.05）。结论高龄老年肺部感染患者细胞免疫功能比体液免疫功能下降明显，体液免疫指标补体C3比C4水平下降敏感，应用Tα1辅助抗感染治疗可有效调节、改善免疫指标，恢复机体免疫功能，促进肺部炎症吸收，改善预后。
目的：觀察瞭解高齡老年肺部感染患者細胞免疫與體液免疫功能變化，探討胸腺肽α1（Tα1）免疫調節輔助抗感染治療免疫功能改善的臨床療效。方法入選≥80歲高齡老年肺部感染患者68例，隨機分為試驗組（Tα1組）和對照組，每組各34例。Tα1組使用基礎治療（抗感染、袪痰、平喘、對癥治療）＋Tα1註射液1.6 mg，皮下註射，每日1次，2週為一箇療程。對照組34例僅使用基礎治療。兩組治療前後對比觀察各項免疫指標：外週血 T 淋巴細胞亞群（CD3＋、CD4＋、CD8＋、CD4＋/CD8＋）；免疫毬蛋白 IgG、IgA、IgM、IgE；補體 C3、C4水平和臨床療效評估。結果 T淋巴細胞錶型變化比較，Tα1組治療前CD3＋為（57.75±7.80）%、CD4＋為（33.43±5.27）%、CD4＋/CD8＋為1.41±0.46，均低于正常值，CD8＋[（30.02±5.60）%]高于正常值。治療後 CD3＋為（66.89±9.84）%、CD4＋為（38.27±4.27）%、CD4＋/CD8＋為1.79±0.59，比治療前均顯著增高，CD8＋[（25.03±4.27）%]比治療前下降，示免疫指標有所改善，相比結果有統計學意義（P＜0.05）。體液免疫指標變化比較：兩組C3水平治療前分彆為（0.89±0.25）g/L、（0.86±0.37）g/L，較正常值均偏低，餘體液免疫指標C4、IgG、IgA、IgE、IgM治療前後相比無統計學差異（P＞0.05）。臨床療效觀察總有效率Tα1組88.2%，高于對照組67.6%，兩組比較有統計學差異（χ2＝8.171，P＜0.05）。結論高齡老年肺部感染患者細胞免疫功能比體液免疫功能下降明顯，體液免疫指標補體C3比C4水平下降敏感，應用Tα1輔助抗感染治療可有效調節、改善免疫指標，恢複機體免疫功能，促進肺部炎癥吸收，改善預後。
목적：관찰료해고령노년폐부감염환자세포면역여체액면역공능변화，탐토흉선태α1（Tα1）면역조절보조항감염치료면역공능개선적림상료효。방법입선≥80세고령노년폐부감염환자68례，수궤분위시험조（Tα1조）화대조조，매조각34례。Tα1조사용기출치료（항감염、거담、평천、대증치료）＋Tα1주사액1.6 mg，피하주사，매일1차，2주위일개료정。대조조34례부사용기출치료。량조치료전후대비관찰각항면역지표：외주혈 T 림파세포아군（CD3＋、CD4＋、CD8＋、CD4＋/CD8＋）；면역구단백 IgG、IgA、IgM、IgE；보체 C3、C4수평화림상료효평고。결과 T림파세포표형변화비교，Tα1조치료전CD3＋위（57.75±7.80）%、CD4＋위（33.43±5.27）%、CD4＋/CD8＋위1.41±0.46，균저우정상치，CD8＋[（30.02±5.60）%]고우정상치。치료후 CD3＋위（66.89±9.84）%、CD4＋위（38.27±4.27）%、CD4＋/CD8＋위1.79±0.59，비치료전균현저증고，CD8＋[（25.03±4.27）%]비치료전하강，시면역지표유소개선，상비결과유통계학의의（P＜0.05）。체액면역지표변화비교：량조C3수평치료전분별위（0.89±0.25）g/L、（0.86±0.37）g/L，교정상치균편저，여체액면역지표C4、IgG、IgA、IgE、IgM치료전후상비무통계학차이（P＞0.05）。림상료효관찰총유효솔Tα1조88.2%，고우대조조67.6%，량조비교유통계학차이（χ2＝8.171，P＜0.05）。결론고령노년폐부감염환자세포면역공능비체액면역공능하강명현，체액면역지표보체C3비C4수평하강민감，응용Tα1보조항감염치료가유효조절、개선면역지표，회복궤체면역공능，촉진폐부염증흡수，개선예후。
Objective To observe the changes of the cellular and humoral immune function in aged patients with lung infection and to investigate the values thymosin α1(Thymosin alpha-1, Tα1) regulates immune function in adjuvant treatment as well as clinical effect. Methods 68 elder patients (≥80 years) with pneumonia, were randomly divided into the treatment group (Tα1) and the control group, 34 cases in each group. Tα1 groups used the basic treatment (anti infection, eliminating phlegm, relieving asthma, symptomatic treatment) plus thymosinα1 injection(subcutaneous injection, once every second day, 2 weeks as a course). The control group of 34 cases using only basic treatment. The two groups were observed before and after treatment and were compared by immune indexes: the peripheral blood T lymphocyte subsets (CD3+, CD4+, CD8+, CD4+/CD8+); immunoglobulin IgG, IgA, IgM, IgE, C4, complement C3 as well as the evaluation of clinical efficacy. Results For the changes of T lymphocyte phenotype, in Tα1 group, CD3+, CD4+, CD4+/CD8+ were (57.75±7.80)%, (33.43±5.27)%, 1.41±0.46 before treatment, lower than normal while CD8+ was (30.02±5.60)%, higher than normal, CD3+, CD4+, CD8+, CD4+/CD8+ were (66.89±9.84)%, (38.27±4.27)%, (25.03±4.27)%, 1.79±0.59 respectively after treatment, demonstrating that CD3+, CD4+, CD4+/CD8+ were significantly increased while CD8+significantly decreased (P<0.05); For the changes of humoral immunity, C3 were (0.89±0.25)g/L, (0.86±0.37)g/L in two groups, lower than normal;As to other humoral immunity indexes (C4, IgM, IgA, IgG), there were no significant difference before and after treatment (P>0.05). For the clinical curative effect of the total efficiency, Tα1 group was 88.2%while control group was 67.6%, a significant difference between two groups (χ2=8.171, P<0.05). Conclusions Thymosin α1 can effectively regulate immune function in adjuvant treatment of aged patients with lung infection, restore immune function, promote the absorption of pulmonary inflammation, improve prognosis of the patient.
