老年慢性阻塞性肺疾病急性期患者自然免疫缺陷与免疫干预研究

目的探讨老年慢性阻塞性肺疾病（COPD）患者急性期自然免疫功能的缺陷,并研究免疫干预治疗的作用。方法采用随机的方法将70例老年COPD住院患者分成干预组35例、对照组35例,另设老年健康对照组20例。患者入院后行常规检查治疗,老年干预组加用口服的非特异免疫调节药匹多的莫德（pidotimod）,观察30d,前15d,口服匹多的莫德,2次/d,2片/次（400mg/片）,后15d维持量,1次/d,2片/次,分别于第1天、第30天用流式细胞仪检测患者外周血CD14、CD158b、HLA-DR的改变,同时观察第10天时临床症状的改善情况。结果干预组、对照组、健康对照组最终纳入分析患者分别为30、28、20例。干预组、对照组外周血CD14、CD158b、HLA-DR参数均较健康对照组低,差异均有统计学意义（P〈0.05）。在常规治疗一致的前提下,加用匹多的莫德的干预组上述免疫参数在治疗30d时均明显升高,差异有统计学意义（P〈0.05）。第10天老年干预组的临床症状如咳嗽、咳痰、肺部湿啰音的改善均较对照组明显,差异有统计学意义（P〈0.05）。结论老年COPD在急性期发作期间自然免疫功能低下。加用非特异性免疫调节剂匹多的莫德（Pidotimod）片后,可改善自身的免疫功能,同时加快了临床症状的恢复。

Innate Immune Deficiency in the Elderly with Chronic Obstructive Pulmonary Disease at Acute Exacerbations and Medication Intervention to It

Objective To investigate innate immune deficiency in elderly patients with chronic obstructive pulmonary disease during acute exacerbations(AECOPD)and effects of the immunostimuulating agent Pidotimod in AECOPD patients.Methods A total of 70 elderly patients with AECOPD were randomized recruited as trial group(n=35)and control group(n=35),with a additional health control group of 20 elderly people.After admission the patients were given routine treatment,but the patients in the trial group were orally given...