胸腺肽α1对老年脓毒血症患者免疫功能的影响

目的探讨老年脓毒血症患者细胞免疫功能的变化，观察胸腺肽α1的治疗效果。方法120例老年脓毒症患者随机分为两组：干预组和对照组，每组60例。对照组给予常规治疗，干预组在常规治疗基础上加用胸腺肽α1 1．6mg,／d，皮下注射，疗程1周。比较两组患者治疗前后细胞免疫功能、APACHEⅡ评分和住院死亡率。结果两组患者治疗前CD4^＋、CD8^＋、CD4^＋／CD8^＋、APACHEⅡ评分差异无统计学意义（P〉0．05）。治疗后干预组CD4^＋、CD4^＋／CD8^＋较常规治疗组明显增高（P〈0．001），CD8^＋明显降低（P〈0．001），APACHEⅡ评分和住院死亡率亦明显降低（P〈0．05）。结论老年脓毒血症患者细胞免疫功能明显降低，胸腺肽α1能改善此类患者的细胞免疫功能，提高临床治疗效果。

Influence of Thymosin alpha 1 on Immune Function of Elderly Pa-tients with Sepsis

Objective To investigate the changes of cellular immune function in elderly patients with sepsis, and observe the therapeutic effect of thymosin alpha 1. Methods A total of 120 elderly patients with sepsis were randomly divided into two groups： intervention group and control group （60 in each group） . Conventional therapy was adopted in the control group. Thymosin alpha 1 at 1 1.6mg/d was subcutaneously given to patients for 1 weeks in the intervention group based on the conventional therapy. The cellular immune function before and after treatment, APACHE Ⅱ score and in-hospital mortality were compared between the two groups. Results There were no significant differences between two groups in CD4^＋ , CD8^＋, CD4/CD8^＋ , and APACHE Ⅱ score before treatment （ P 〉 0. 05 ） . After treatment, CD4^＋ and CD4^＋/CD8^＋ were significantly increased （P 〈 0. 001 ）, but CD8^＋ decreased obviously in the intervention group as compared with control group （P 〈 0. 001 ）. APACHE Ⅱ score and in-hospital mortality were lower in the intervention group than in the control group （P 〈 0. 05） . Conclusion The eellular immune function of elderly patients with sepsis is impaired significantly. Thymosin alpha 1 can profoundly improve the clinical therapeutic outcomes of such patients by increasing their cellular immune funetion.