草分枝杆菌注射剂预防AECOPD作用及对COPD患者Th_1/Th_2平衡的影响

目的：探讨草分枝杆菌注射剂（乌体林斯）对COPD患者Th1／Th2细胞平衡的影响，及预防慢性阻塞性肺疾症急性加重发作（AECOPD）的临床疗效。方法：将60例Ⅱ级COPD患者随机分为治疗组和对照组，对照组予以常规治疗，治疗组在常规治疗基础上加用乌体林斯，观察乌体林斯治疗前后COPD患者外周血γ-干扰素（IFN-γ）、白介素4（IL-4）的变化，以及临床疗效。结果：治疗组IFN-γ／IL-4比值从治疗前的1．39±0．20，增加为治疗后的1．94±0．31（P〈0．01）；对照组变化不明显。治疗组显效率26．7％，总有效率96．7％，明显高于对照组的0和20％；两组临床疗效经Ridit分析，差异有统计学意义（P〈0．01）。结论：乌体林斯通过调节Th1／Th2细胞平衡，显著改善了COPD患者的免疫功能，预防AECOPD效果显著，有一定的临床推广价值。

Effects of Mycobacterium Phlei on Funcitonal States of Th_1/Th_2 in Patients with COPD and Preventive Effects on AECOPD

Objective： To investigate the effects of Mycobacterium Phlei on functional states of Th1/Th2 in patients with chronic obstructive pulmonary disease （COPD） , and clinical effects on the prevention of acute exacerbation of chronic obstructive pulmonary diseases （AECOPD）. Method： 60 patients with COPD of grade Ⅱ were randomly divided into a treatment group and controlled group. The controlled group were given a routine therapy, while the treatment group were given utilins in addition to the routine treatment. The contents of γ-interferon （IFN-γ） and interleukin-4 （IL-4） in their peripheral blood and their clinical efficacy were observed before and after the treatment. Result： Before and after the treatment, IFN-γ/IL-4 ratio in the treatment group was 1.39 ± 0.20 and 1.94 ± 0.31 respectively （P 〈 0. 01 ） and that of the controlled group did not change significantly. The obvious effective rate was 26.7% and the total effective rate was 96. 7%, it was siguificandy higher than that of the controlled group （0% and 20% ）. There were significant difference in the clinical efficacy between 2 groups （P 〈 0.01 ）. Conclusion： By regulating the Th1/Th2 balance, utilins significantly improved the immune function in patients with COPD, and has a remarkable effect on the prevention of AECOPD, which can be widely used in clinic.