细胞免疫增强剂与雾化吸入治疗老年COPD并发肺部感染患者的临床研究  

Clinical study of cellular immunopotentiator and aerosol inhalation in the treatment of elderly COPD patients complicated with pulmonary infection

作　　者：陈丽丽 张瑞珍[1] 吴茱萸[1] 李太杰 CHEN Li-li;ZHANG Rui-zhen;WU Zhu-yu;LI Tai-jie(Respiratory and Critical Care Medicine,Luohe Central Hospital,Luohe,Henan 462005,China;Dermatology Department,Luohe Central Hospital,Luohe,Henan 462005,China)

机构地区：[1]漯河市中心医院呼吸与危重症医学科,河南漯河462005 [2]漯河市中心医院皮肤科,河南漯河462005

出　　处：《医药论坛杂志》2023年第8期20-24,共5页Journal of Medical Forum

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20221026)。

摘　　要：目的探讨细胞免疫增强剂与雾化吸入治疗老年COPD并发肺部感染患者的临床研究。方法前瞻性从漯河市中心医院选取2018年10月到2020年2月收治的110例老年COPD并发肺部感染患者,用数字表法随机分配成对照组以及观察组,每组各55例患者。对照组给予异丙托溴铵及布地奈德雾化吸入,观察组在对照组基础上加用胸腺肽注射液。比较两组临床症状改善时间、炎症反应、免疫功能、肺功能、两组动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、病情严重程度以及临床发生的不良反应。结果观察组临床症状改善时间对比对照组明显缩短(P<0.05);在治疗后,两组患者的肿瘤坏死因子-α,降钙素原及急性生理与慢性健康状况、临床肺部感染的评分与治疗前进行对比有显著的降低(P<0.05),且观察组对比对照组有明显下降(P<0.05);治疗后,两组CD3^(+)、自然杀伤细胞、CD4^(+)/CD8^(+)以及第1秒用力呼气量、用力肺活量、最大呼气中期流速水平与治疗前对比有比较明显的提高(P<0.05),且观察组与对照组进行对比提高更为明显(P<0.05);两组PaO_(2)与治疗前比较有明显的提升,且观察组与对照组进行比较,提高更为明显(P<0.05),两组PaCO_(2)与治疗前对比有明显的下降,且观察组与对照组进行对比,下降更为明显(P<0.05);治疗期间两组均未出现明显不良反应。结论细胞免疫增强剂联合异丙托溴铵、布地奈德雾化吸入治疗老年COPD并发肺部感染可有效改善患者临床症状、免疫功能及肺功能,减轻炎症反应,促进患者康复,且安全性较好。Objective To investigate the clinical study of cellular immune enhancer combined with aerosol inhalation in the treatment of elderly COPD complicated with pulmonary infection.Methods Totally 110 elderly patients with COPD complicated with pulmonary infection who were admitted to Luohe Central Hospital from October 2018 to February 2020 were prospectively divided into a control group and an observation group,55 cases in each group.The control group was given ipratropium bromide and budesonide aerosol inhalation,and the observation group was given thymosin injection on the basis of the control group.The clinical symptoms,inflammatory response,immune function,pulmonary function,partial pressure of oxygen(PaO_(2)),partial pressure of carbon dioxide(PaCO_(2)),disease severity and adverse reaction improvement time were compared between the two groups.Results The improvement time the clinical symptoms of the observation group were significantly improved shorter than that in the control group(P<0.05).After treatment,tumor necrosis factor-α,procalcitonin,acute physiological and chronic health status,and clinical lung infection scores in the two groups were significantly decreased(P<0.05),and the observation group was significantly decreased.Compared with the control group(P<0.05).After treatment,CD3^(+),natural killer cells,CD4^(+)/CD8^(+),forced expiratory volume in 1 second,forced vital capacity and maximal expiratory flow rate in the two groups were significantly higher than those before treatment(P<0.05),and the observation group was significantly higher than those of the control group(P<0.05).Compared with the control group,PaO_(2) in the two groups increased before treatment,and the observation group increased significantly(P<0.05),while the PaCO_(2) decreased in the two groups before treatment,and the observation group decreased significantly(P<0.05).During the treatment period,there were no obvious adverse reactions in both groups.Conclusion Cellular immune enhancer combined with ipratropium bromide and budesonid

关 键 词：老年慢性阻塞性肺疾病 肺部感染 胸腺肽 治疗效果 

分 类 号：R563[医药卫生—呼吸系统]