胸腺肽对重症呼吸机相关性肺炎患者心肌相关标志物和T淋巴细胞亚群的影响

摘要

Objective To investigate the effect of thymosin on myocardial related markers and T lymphocyte subsets in patients with severe ventilator-associated pneumonia.Methods A total of 34 patients with severe ventilator-associated pneumonia were selected from October 2014 to December 2016 at the Suizhou Hospital Affiliated to Hubei medical college. Patients and their families selected the treatment methods.The patients were divided into observation group and control group. Patients in the control group according to sputum culture and drug sensitivity results given antibiotics and primary disease treat -ment,patients in the observation group based on the increase of thymosin alpha 1 1.6 mg injection,continuous injection of 10 d of 2 groups were treated for 3 weeks.After 10 d,the creatine kinase isoenzyme(CK-MB),lactate dehydrogenase(LDH), brain natriuretic peptide(BNP), neuropeptide Y(NPY)level and T lymphocyte subsets were observed in 2 groups of pa-tients.Results The observation group of patients' mechanical ventilation time,hospitalization time and mortality were shorter than/less than that of the control group(t =3.052,χ2=2.270,χ2=5.669,P <0.05);after treatment,the observation group's CK-MB,LDH,BNP,NPY were lower than the control group(24.36 ±6.01)U/L vs.(37.49 ±8.83)U/L and(268.44 ± 38.56)U/L vs.(303.70 ±51.33),U/L(57.02 ±14.62)pg/ml vs.(83.49 ±15.24),pg/ml(269.51 ±36.69)pg/ml vs. (288.76 ±39.66)pg/ml,P <0.05;after treatment,the observation group's CD4+was higher than the control group(42.09 ± 2.46 vs.38.86 ±2.81,t =3.512,P =0.001),and CD8+,CD4+/CD8+were lower than that of control group(24.66 ±2.32 vs.27.47 ±3.06,t =2.946,P =0.049;1.71 ±1.06 vs.1.41 ±0.96,t =0.883,P =0.084).Conclusion Thymosin in the treatment of severe ventilator-associated pneumonia has good effect and high safety,and is worthy of clinical use.%目的 观察胸腺肽对重症呼吸机相关性肺炎患者心肌相关标志物和T淋巴细胞亚群的影响.方法 选择2014年10月—2016年12月湖北医药学院附属随州医院重症医学科治疗的重症呼吸机相关性肺炎患者34例作为研究对象.按患者及家属自愿选择治疗方式分为观察组(n=15)与对照组(n=19).对照组患者依照痰培养药敏结果给予相应敏感抗菌药物以及原发疾病治疗,观察组患者在此基础上增加胸腺肽α11.6mg皮下注射,连续注射10d.2组疗程均为3周.3周后观察2组患者的肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)、脑钠肽(BNP)、神经肽Y(NPY)水平以及T淋巴细胞亚群.结果 观察组患者的机械通气时间、住院时间以及病死率均短于/低于对照组(t=3.052,χ2=2.270,χ2=5.669,P<0.05);治疗后,观察组的CK-MB、LDH、BNP、NPY均低于对照组[(24.36±6.01)U/L vs.(37.49±8.83)U/L、(268.44±38.56)U/L vs.(303.70±51.33)U/L、(57.02±14.62)pg/ml vs.(83.49±15.24)pg/ml、(254.20±36.69)pg/ml vs.(288.76±39.66)pg/ml,P<0.05];治疗后,观察组的CD4+高于对照组[(42.09±2.46)%vs.(38.86±2.81)%,t=3.512,P=0.001],而CD8+则低于对照组[(24.66±2.32)%vs.(27.47±3.06)%,t=2.946,P=0.049).结论 胸腺肽辅助治疗重症呼吸机相关性肺炎效果良好,安全性高,值得临床推广使用.