胸腺肽联合阿奇霉素治疗老年COPD继发肺部感染疗效及对肺功能和血气指标的影响

摘要

目的 观察胸腺肽注射液联合阿奇霉素治疗老年慢性阻塞性肺疾病(COPD)继发肺部感染的临床疗效及对肺功能和血气指标的影响.方法 选择2014年1月—2015年1月北京军区总院263医院呼吸科收治的老年慢性阻塞性肺疾病继发肺部感染患者90例,按照随机数字表法分为2组.对照组45例,患者在常规治疗的基础上加用阿奇霉素,观察组45例,患者在对照组的基础上加用胸腺肽注射液进行治疗.治疗后比较分析2组的临床疗效,以及肺功能和血气指标的变化,评估其生活质量和临床症状的变化,并观察分析观察组治疗前后T细胞亚群的变化.结果 治疗后,观察组总有效率为91 A.11%,显著高于对照组73.33%(χ2=4.865,P<0.05).观察组治疗后PaO2、PaCO2均改善,分别为(9.61±1.72)mmHg、(4.95±0.76)mmHg,且优于对照组的(8.84±1.67)mmHg、(5.40±0.74)mmHg(P<0.05),观察组肺功能、临床症状和生活质量也得到了有效的改善(P<0.05),而对照组仅临床症状、生活质量有显著改善(P<0.05),肺功能无显著变化(P>0.05),且观察组均明显优于对照组(P<0.05).治疗后,观察组患者的CD4+细胞明显升高,CD8+细胞明显降低,其CD4+/CD8+比值明显增加(P<0.01).结论 胸腺肽注射液联合阿奇霉素治疗老年慢性阻塞性肺疾病继发肺部感染患者,可有效改善患者的肺功能,并降低PaCO2水平,提高PaO2水平,提高其治疗的总有效率.%Objective To observe clinical efficacy of thymosin injection combined with azithromycin on elderly pa-tients with chronic obstructive pulmonary disease secondary to pulmonary infection and effect on lung function and blood gas in-dicators.Methods 90 elderly patients with chronic obstructive pulmonary disease secondary to pulmonary infection treated in the Department of Respiratory, the 263 Hospital of Beijing Military Region from January 2015 to January 2014 were selected and divided into 2 groups according to the random number table method.45 cases in the control group, patients on the basis of conventional therapy also combined with azithromycin, 45 cases in the observation group, patients based on the treatment in the control group also treated with thymosin injection.After treatment, the clinical efficacy of the 2 groups were compared, the changes of lung function and blood gas indexes, the changes of their quality of life and clinical symptoms were assessed, and the changes of T cell subsets in the observation group were observed and analyzed.Results After treatment, the total effective rate of observation group was 91.11%, which was significantly higher than the control group (73.33%,χ2 =4.865, P <0.05).Observation group's PaO2 and PaCO2 were improved, (9.61 ±1.72) mmHg and (4.95 ±0.76) mmHg respectively, and better than that of the control group's (8.84 ±1.67) mmHg and (5.40 ±0.74) mmHg ( P <0.05), observation group's pulmonary function, clinical symptoms and quality of life had also been effectively improved ( P <0.05) , while the control group only clinical symptoms, quality of life had improved significantly ( P <0.05) and pulmonary function without significant change ( P >0.05), and the observation group were significantly better than the control group ( P <0.05).After treatment, the observation group patient's CD4 +cells significantly increased, CD8 +cells decreased significantly, the CD4 +/CD8+ ratio significantly increased ( P <0.01).Conclusion Thymosin combined with azithromycin in the treatment of elder- ly patients with chronic obstructive pulmonary disease secondary pulmonary infection patients can effectively improve the patient's pulmonary function, and reduce the level of PaCO2 , improve level of PaO2 and improve the treatment efficiency.