胸腺肽α1辅助治疗老年慢性阻塞性肺疾病急性加重期患者疗效的Meta分析  

The curative effect of thymosin-α1 in the adjuvant treatment of senile patients with AECOPD:a Meta-analysis

作　　者：吴晓玲[1] 王桦[1] 葛亮[1] 汪琪[1] 张艳芳[1] 

机构地区：[1]武汉大学中南医院老年病科,430071

出　　处：《中华临床医师杂志（电子版）》2015年第1期87-91,共5页Chinese Journal of Clinicians(Electronic Edition)

基　　金：湖北省自然科学基金(2013CFB262)

摘　　要：目的系统评价胸腺肽α1辅助治疗老年慢性阻塞性肺疾病急性加重期(AECOPD)患者的临床疗效。方法检索Cochrane library、Pub Med、中国学术期刊全文数据库(CNKI)、万方和维普等数据库中有关胸腺肽α1辅助治疗老年AECOPD患者的临床随机对照研究,采用Jadad质量评价量表对纳入文献进行质量评价,提取总有效率、T细胞免疫指标、住院时间、感染复发率指标等结局资料,应用Rev Man 5.2软件进行Meta分析。结果 11项临床随机对照研究共计862例病例纳入分析,其中应用常规抗炎、祛痰等治疗者429例(对照组),在常规治疗基础上加用胸腺肽α1者433例(研究组)。Meta分析结果显示,研究组患者总有效率与对照组相比显著提高[OR=3.14,95%CI(1.91,5.14)];血清中T淋巴细胞亚群CD3+、CD4+、CD4/CD8水平也较对照组明显上升[WMD,95%CI分别为5.77(4.25,7.28)、6.06(4.84,7.28)、0.39(0.24,0.54)],而CD8+水平明显下降[WMD=-2.80,95%CI(-4.69,-0.91)]。此外,结果还显示加用胸腺肽α1治疗可缩短患者住院时间[WMD=-5.26,95%CI(-7.39,-3.13)],降低患者感染复发率[OR=0.12,95%CI(0.05,0.28)]。以上各项指标两组间差异均有统计学意义(P<0.01)。结论胸腺肽α1辅助治疗老年AECOPD可以明显提高患者临床疗效,改善机体免疫功能,降低住院时间及再次感染复发率。Objective To systematically assess the curative effect of thymosin-α1 in the adjuvant treatment of senile patients with AECOPD. Methods The Cochrane library, PubMed, CNKI, Wanfang, and VIP datebases were retrieved via computer system for randomized controlled trails （RCTs） with the adjuvant treatment of thymosin-α1 in senile patients with AECOPD, quality of studies was evaluated by the Cochrane Jadad rating scale. The total effective rate, T cellular immune function indices, the length of stay in hospital, infection relapse were collected. Meta analysis was conducted with Rev Man 5.2. Results 11 relevant RCTs studies with 862 cases were enrolled, including 433 patients in the study group （thymosin-α1 group）, and 429 in the control group. Meta analysis showed that patients in the study group had significantly higher effective rate than that in the control group[OR=3.14, 95% CI （1.91, 5.14）], and the serum level of CD3＋, CD4＋, CD4/CD8 also were significantly higher in the study group, the value of WMD and 95% CI were 5.77 （4.25, 7.28）, 6.06 （4.84, 7.28）, 0.39 （0.24, 0.54）, respectively, but there was significant lower level of CD8＋ [WMD=-2.80, 95% CI （-4.69, -0.91）]. In addition, the incidence of infection relapse in thymosin-α1 group was lower than control group [OR=0.12, 95% CI （0.05, 0.28）], and the mean hospital days were reduced as well [WMD=-5.26, 95% CI （-7.39, -3.13）], all of them were statistically significant （P〈0.01）. Conclusion The thymosin-α1 as a adjuvant treatment in senile patients with AECOPD can significantly improve the patients, curative effect, enhance the body cellular immune＆amp;nbsp;function, and it also can reduce the recurrence of infection and the length of stay in hospital.

关 键 词：肺疾病 慢性阻塞性 老年人 T淋巴细胞亚群 META分析 胸腺肽Α1 Thymosin-α1 

分 类 号：R563.9[医药卫生—呼吸系统]