目的：探讨卡介苗素治疗对慢性阻塞性肺疾病（COPD）患者细胞免疫功能的调节作用及其意义。方法将60例COPD患者随机分为实验组和对照组各30例，对照组接受常规治疗，实验组在常规治疗基础上予卡介苗素0.35mg肌肉注射，隔日1次，共3个月。两组患者均随访6个月，观察COPD复发率及控制感染时间，检测两组患者0、3、6个月时血清中IFN-γ及IL-4水平及0、6个月时肺功能。结果0个月时两组患者细胞因子水平及肺功能的差异均无统计学意义（均P＞0.05）。3个月时实验组IFN-γ水平高于对照组，IL-4水平低于对照组，差异均无统计学意义（均P＞0.05），IFN-γ/IL-4比值高于对照组，差异有统计学意义（P＜0.05）。6个月时实验组IFN-γ水平高于对照组，差异无统计学意义（P＞0.05），IL-4水平低于对照组，差异有统计学意义（P＜0.05），IFN-γ/IL-4比值及FEV1占预计值高于对照组，差异均有统计学意义（P＜0.05或0.01）。随访6个月内实验组COPD复发率及控制感染时间均少于对照组，差异均有统计学意义（均P=0.020）。结论卡介苗素能增强COPD患者细胞免疫功能，改善其预后。%Objective To investigate the immunoregulatory activity of BCG- PSN in patients with chronic obstructive pul-monary disease (COPD). Methods Sixty COPD patients were randomly assigned to BCG group and control group with 30 in each. Conventional treatment was given to both groups, patients in BCG group also received BCG- PSN 0.35mg i.m, q.o.d for 3 months. Both groups were fol owed up for 6 months. The recurrence rate of COPD, the time of infection control were observed in two groups. Serum levels of IFN- γ, IL- 4 at 0, 3, 6 months after treatment were measured and lung function at 0, 6 months af-ter treatment was examined. Results There were no differences in cytokines levels and lung function before treatment between two groups (P>0.05). There was also no difference in serum IFN- γand IL- 4 levels 3 months after treatment (P>0.05), but the IFN- γ/IL- 4 ratio in BCG group was higher than that in control group (P<0.05). On 6 months after treatment, serum IL- 4 levels were lower in BCG group (P<0.05), there was no difference in IFN- γlevels between two groups (P>0.05);however, the IFN- γ/IL- 4 ratio in BCG group was higher than that in control group (P<0.05), and percentage of FEV1/predicted was higher(P<0.01). The recurrence rate of COPD was lower and the time of infection control was shorter in BCG group than those in control group (P<0.05). Conclusion BCG- PSN can enhance cellular immune function and improve the prognosis of pa-tients with COPD.
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