不同时期慢性阻塞性肺疾病患者免疫的变化及胸腺肽的影响  

Clinical significance of immune function in patients with chronic obstructive pulmonary disease (COPD) at different stage

作　　者：喻杰[1] 胡仁梅[1] 黎云霞[1] 傅晶晶 张志勇[1] 罗琳琳[1] 李秋根[1] YU Jie;HU Renmei;LI Yunxia;FU Jingjing;ZHANG Zhiyong;LUO Linlin;LI Qiugen(Jiangxi People’s Hospital,Nanchang,330006,China.)

机构地区：[1]江西省人民医院,南昌330006

出　　处：《江西医药》2018年第1期1-3,共3页Jiangxi Medical Journal

基　　金：江西省科技厅自然基金资助项目;编号2014IBBG70045;江西省卫计委普通科技计划项目;编号20165008

摘　　要：目的探讨不同时期的慢性阻塞性肺疾病(Chronic obstructive pulmonary disease,COPD)患者的免疫功能的临床意义,评估胸腺肽α1药物临床治疗的疗效。方法选取2015年1月至2017年5月我科住院的80例COPD患者,其中40例COPD稳定期患者为稳定期组,40例COPD急性加重期患者为急性加重期组,另选择40例健康人群为对照组,常规检测各组T细胞亚群CD3^+、CD4^+/CD8^+以及补体C3、C4,评估各组患者的免疫状态,然后急性加重期组患者在传统抗感染、祛痰、平喘和吸氧支持的基础上同时接受12周胸腺肽1.6ug每周两次治疗,也就是药物治疗组,再进行T细胞亚群CD3^+、CD4^+/CD8+以及补体C3、C4检测,评估药物干预后患者的免疫状态,另选择40例急性加重期患者给予传统治疗基础作为加重期对照组,与药物治疗组两年内急性加重发作次数及平均住院天数比较,探讨药物干预在减少COPD急性发作的临床意义。结果通过检测血清T细胞亚群CD3^+、CD4^+/CD8^+以及补体C3、C4,发现不同时期COPD患者血清T细胞亚群CD3^+、CD4^+/CD8^+均有下降(P<0.05),急性加重期下降更明显(P<0.05),说明COPD患者免疫力与所处时期密切相关,血清补体C3、C4在各组中比较无明显统计学差异(P>0.05)。应用胸腺肽α1治疗COPD急性加重期组患者T细胞亚群CD3^+、CD4^+/CD8^+升高,免疫状态得到改善,且急性加重次数及住院天数均较急性加重期对照组减少(P<0.05)。结论 COPD患者均存在免疫状态下降,胸腺肽α1可以提高COPD患者免疫状态,同时可以减少COPD患者急性发作次数及缩短住院天数,减轻家庭及社会经济压力。Objective To investigate the clinical significance of immune function in patients with chronic obstructive pulmonary disease(COPD)at different stage and to evaluate the therapeutic effect of thymosin-α1 drug.Methods 80 patients with COPD were enrolled in our hospital from January 2015 to May 2017,40 patients with stable COPD(stable group),40 patients with acute exacerbation of COPD(acute exacerbated group),and 40 healthy people as health control group.CD3+,CD4+/CD8+and complement C3 and C4 were detected in each group.The acute exacerbation group were treated with traditional anti-infective,expectorant,etc,The levels of CD3+,CD4+/CD8+and complement C3,C4 were examined in the treatment group,and the immune status of the patients was evaluated after the intervention of 12 weeks of thymosin-α1 1.6ug hypodermic injection twice a week,that is the drug treatment group.Another 40 patients with acute exacerbation of COPD were treated with traditional anti-infective as acute exacerbated control group to compare the number of acute exacerbations and the average length of hospital stay in the two-year period between the stable group and the drug treatment group,and to explore the clinical significance of drug intervention in reducing the acute exacerbate of COPD.Results The levels of CD3+and CD4+/CD8+in stable group and exacerbation group were decreased compared with the controls(P<0.05),The decline in acute exacerbated group was more obvious compared with the stable group.Complement C3 and C4 showed no correlation(P>0.05)in the three groups.Compared with the stable group,the levels of CD3+,CD4+/CD8+were increased(P<0.05),and the number of acute exacerbations and the number of hospital days were decreased(P<0.05)in acute exacerbated group.Conclusion Immune function decreased can be observed in patients with chronic obstructive pulmonary disease(COPD)at different stage.The treatment of thymosin-α1 can improve the immune status of patients with COPD,and reduce the number of acute exacerbations and shorten the number of hosp

关 键 词：慢性阻塞性肺疾病(COPD) T淋巴细胞亚群 补体 胸腺肽Α1 

分 类 号：R563.9[医药卫生—呼吸系统]