目的：比较3种常用免疫增强剂联合抗生素预防老年恶性肿瘤术后感染的有效性及经济性。方法：纳入外科480例老年恶性肿瘤患者，并随机分为甘露聚糖肽注射液组、胸腺五肽组、胸腺肽α1组和空白组各120例，均行外科肿瘤根治性手术。三个治疗组术前3天至术后一周应用免疫增强剂，给药方法为甘露聚糖肽注射液10～20mg/d，胸腺五肽2ml/d，胸腺肽α13.2mg/周，空白组则不予应用免疫增强剂，术后均选用抗生素滴注，观察两组的呼吸道、泌尿系统、切口感染及其他感染情况，并对4种药物的治疗方案行经济学评价。结果：四组肿瘤患者呼吸道感染发生率分别为2.5%、3.34%、3.34%，14.16%；泌尿系统感染发生率分别为3.34%，6.67%，5.83%，15%；切口感染发生率分别为2.5%，18.35%，17.5%，15%；总感染发生率分别为15%，19.16%，18.33%，48.33%，免疫增强组术后感染的发生率明显低于空白组，其中甘露聚糖肽组预防切口感染率优势更佳，且具有统计学差异（P＜0.05），甘露聚糖肽成本-效益是免疫增强剂中最佳。结论：免疫增强剂能降低老年恶性肿瘤患者术后感染发生率，但上述三种免疫增强剂在降低总感染发生率上不具有统计学差异，甘露聚糖肽在降低切口感染方面可能优于其他2种免疫增强剂，药物经济学分析甘露聚糖肽更为经济。%[ABSTRACT]Objective:To compare the effectiveness and economical efifciency of three common immunopotentiators with antibiotic on postoperative infection of elderly cancers. Methods: 480 elderly cancer patients hospitalized in the surgical oncology and geriatrics of XX center were randomly divided into mannatide injection group, thymopentin group, thymosin α1 group and blank group, with each 120 patients. Four groups underwent radical surgical tumor surgery. From preoperative 3 days to a week after surgery, three treatment groups were given with immunopotentiators, mannatide injection 10~20mg/d, thymopentin 2 ml/d, thymosin α1 3.2 mg/week, whereas blank group received no immunopotentiators. Each group was infused with postoperative antibiotics injection. Observe the infection of respiratory, urinary system, wound and other infection, and evaluate the economical efifciency of four kinds of therapy. Results:Incidences of respiratory infection in four groups were 2.5%, 3.34%, 3.34%, 14.16%. Incidences of urinary infection were 3.34%, 6.67%, 5.83%, 15%. Incidences of wound infection were 2.5%, 18.35%, 17.5%, 15%. Total incidences of infection were 15%, 19.16%, 18.33%, 48.33%. Incidences of postoperative infection in immune-enhancing groups were significantly lower than blank group. Particularly mannatide group worked better on prevention of wound infection, with signiifcant difference (P<0.05), and cost-efifciency of mannatide was the best. Conclusion: The immune enhancer can reduce the incidence of postoperative infections in elderly cancer patients, but these three immunopotentiators were not statistically different in reducing the total incidence of infection. Mannatide may be superior in reducing wound infections to other two kinds of immunopotentiators, and pharmacoeconomic analysis showed mannatide was more economical.
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