老年慢性阻塞性肺疾病患者细胞免疫功能变化及胸腺肽α1疗效观察

目的 了解老年慢性阻塞性肺疾病(COPD)患者急性加重期和稳定期细胞免疫功能及观察胸腺肽α1的临床疗效. 方法老年中重度COPD急性加重期患者60例,分为胸腺肽α1治疗组32例,对照组28例,分别于治疗前、治疗后1周及稳定期测定外周血T细胞哑群及NK细胞.结果 COPD患者急性加重期治疗组CD3、CD4、CD4/CD8及NK细胞分别为(59.36±4.22、24.23±6.48、0.81±0.68、11.55±3.25)比稳定期患者(70.60±4.71、38.72±5.86、1.54±0.45、21.32±3.62)降低(F=21.68、43.97、18.45、25.68,均P<0.01);CD3、CD4、CD4/CD8及NK细胞治疗1周后治疗组(63.54±5.45、30.65±3.32、1.12±0.57,17.42±4.47)与对照组(60.18±6.32、27.29±4.30、1.04±0.51、15.21±4.26)比升高(t=2.19、4.02、3.43、3.01,均P<0.01);稳定期CD3、CD4、CD4/CD8及NK细胞治疗组(70.60±4.71、38.72±5.86、1.54±0.45,21.32±3.62)较对照组(65.44±5.82、32.45±3.88、1.17±0.63、19.49±5.67)升高(t=2.92、3.09、3.10、3.24,均P<0.01). 结论老年(COPD患者急性加重期较稳定期细胞免疫功能明显降低.胸腺肽α1对老年COPD急性发作期和稳定期患者细胞免疫功能的恢复有效.

The immune function of the elder patients with chronic obstructive pulmonary disease and the effects of thymosin alpha 1 on it

Objective To investigate the immune function of the elder patients with chronic obstructive pulmonary disease (COPD) and the effects of thymosin aphal (T-a1) on it. Methods A total of 60 elder patients with acute exacerbation of COPD were randomly divided into 2 groups, the T-αl treatment group (n=32) and the control group (n = 28). The levels of T cell subset and natural killer cell (NK cell) were detected at the beginning, one week after treatment and at stable phase. Results The levels of CDS, CD4, CD4/CD8 and NK cell were lower in acute phase (59. 36 ±4. 22, 24.23±6.48, 0.81 ±0.68 and 11. 55 ±3. 25) than in stable phase (70. 60 ±4. 71, 38. 72 ±5. 86, 1.54±0. 45 and 21. 32±3. 62 ,F=21. 68,43. 97,18.45,25. 68 respectively, all P < 0. 01). The levels of CD3, CD4, CD4/CD8 and NK cell were higher at one week after treatment (63. 54±5. 45, 30. 65 ±3.32, 1. 12±0. 57 and 17.42±4. 47) than in control group (60. 18±6.32, 27.29 ±4.30, 1.04±0.51 and 15.21±4. 26, t=2. 19,4.02,3.43,3.01 respectively, all P < 0.01). The levels of CD3, CD4, CD4/CD8 and NK cell were higher in stable phase (70.60±4. 71, 38. 72±5. 86, 1.54 ±0.45 and 21. 32±3. 62) than in control group (65. 44 ±5. 82, 32. 45±3. 88, 1. 17±0. 63 and 19. 49 ±5. 67, t = 2. 92,3. 09,3. 10,3. 24 respectively, all P<0. 01). Conclusions The immune function of the elder patients is lower in acute COPD than in stable COPD. The T-a1 can improve the immune function of the elder patients.