胸腺肽联合血必净治疗对AECOPD合并脓毒症患者外周血PCT、CRP、IL-6及淋巴细胞表达的影响  

Effects of thymosin combined with xuebijing on expressions of peripheral blood PCT,CRP,IL-6,and lymphocytes in patients with AECOPD and sepsis

作　　者：吴佳妮[1] 成群 高光霞 徐华 WU Jiani;CHENG Qun;GAO Guangxia;XU Hua(Department of Intensive Care Medicine,the Sixth People's Hospital of Chengdu,Chengdu 610051,Sichuan,China)

机构地区：[1]成都市第六人民医院重症医学科,四川成都610051

出　　处：《贵州医科大学学报》2022年第4期472-476,共5页Journal of Guizhou Medical University

基　　金：四川省科技计划项目(2019YJ0659)。

摘　　要：目的观察胸腺肽联合血必净对慢性阻塞性肺疾病急性加重期(AECOPD)合并脓毒症患者外周血降钙素原(PCT)、C反应蛋白(CRP)、白细胞介素-6(IL-6)及淋巴细胞的影响。方法130例AECOPD患者均分为观察组与对照组,对照组在常规治疗的基础上给予血必净治疗,观察组在对照组治疗的基础上皮下注射胸腺肽α1(1.6 mg/次,1次/d)、疗程均为10 d;比较两组患者治疗10 d时的临床疗效,比较两组患者治疗前及治疗10 d时的二氧化碳分压(PaCO_(2))、血氧分压(PaO_(2))、氧饱和度(SaO_(2))、PCT、CRP、IL-6、辅助型T细胞1/辅助型T细胞2(Th1/Th2)、调节性T细胞(Treg)水平。结果治疗10 d时,观察组患者总有效率高于对照组,差异有统计学意义(P<0.05);两组患者治疗10 d时的PaCO_(2)均较治疗前降低,PaO_(2)、SaO_(2)均较治疗前升高,且观察组变化更显著(P<0.05);两组患者治疗10 d时的外周血PCT、CRP、IL-6水平及Treg细胞比例均较治疗前降低,Th1/Th2较治疗前升高,且观察组变化更显著(P<0.05)。结论胸腺肽联合血必净对AECOPD合并脓毒症患者的疗效优于单一血必净,可改善患者的免疫状态、抑制炎症及改善血气指标。Objective To observe the effects of thymosin combined with Xuebijing on peripheral blood procalcitonin(PCT),C-reactive protein(CRP),interleukin-6(IL-6),and lymphocytes in patients with sepsis and acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods A hundred and thirty patients with AECOPD were divided into observation group and control group.The control group was treated with Xuebijing on the basis of routine treatment,and the observation group was treated with Thymosinα1(1.6 mg/time,once/d)on the basis of treatment in the control group.The course of treatment was 10 d.The clinical efficacy after 10 d of treatment,as well as partial pressure of carbon dioxide(PaCO_(2)),partial pressure of oxygen(PaO_(2)),oxygen saturation(SaO_(2)),peripheral blood inflammatory indicators(PCT,CRP,IL-6)and helper T cell 1/helper T cell 2(Th1/Th2)and regulatory T cell(Treg)before treatment and after 10 d of treatment were compared between the two groups.Results After 10 d of treatment,the total effective rate of treatment in observation group was higher than that in control group(P<0.05).The PaCO_(2) of the two groups was decreased compared with that before treatment,and PaO_(2) and SaO_(2) were increased compared to before treatment.These changes were more significant in the observation group(P<0.05).The levels of peripheral blood PCT,CRP,IL-6,and the proportion of Treg cells in the two groups were reduced at 10 d after treatment,while Th1/Th2 was higher than that before treatment.These changes were more significant in the observation group(P<0.05).Conclusion Thymosin combined with Xuebijing in treating AECOPD patients with sepsis can improve the immune status,inhibit inflammation,and improve blood gas indicators.

关 键 词：胸腺肽 血必净 慢性阻塞性肺疾病急性加重期 脓毒症 钙素原 C反应蛋白 白细胞介素-6 淋巴细胞 

分 类 号：R563[医药卫生—呼吸系统]