摘要
目的探究胸腺肽α1干预治疗对脓毒症打击后出现持续性炎症-免疫抑制-分解代谢综合征(PICS)的老年患者免疫、代谢功能及预后的影响。方法回顾性分析了2014年1月至2016年12月68例在老年内科重症监护病房(MICU)进行治疗的脓毒症打击后发生PICS的老年患者,将接受胸腺肽α1持续2周干预治疗的34例患者作为观察组,未接受胸腺肽α1干预治疗的34例患者作为对照组。首先通过对比两组间一般临床资料和治疗前后检测指标的变化差异,分析胸腺肽α1对患者免疫和代谢功能的影响;再通过生存分析和对比两组患者各阶段病死率,分析胸腺肽α1对患者预后的影响。结果观察组与对照组治疗前后单核细胞、CD4/CD8和HLADR/CD14的差值存在明显差异[(0.11±0.31)×109/L vs.(-0.16±0.36)×109/L,(0.20±0.94)vs.(-0.22±0.74),(5.8±16.3)%vs.(-3.3±18.2)%],差异有统计学意义(P<0.05)。即胸腺肽α1干预使单核细胞、CD4/CD8和HLADR/CD14明显升高。Kaplan-Meier生存分析结果提示,两组总体预后情况差异无统计学意义(P>0.05)。对各阶段病死率进一步分析结果显示,两组28、90、120 d内病死率和总病死率对比[8(23.5%)vs.12(35.3%),18(52.9%)vs.25(73.5%),20(58.8%)vs.27(79.4%),24(70.6%)vs.28(82.4%)],差异无统计学意义(P>0.05)。结论胸腺肽α1可改善脓毒症后的PICS老年患者的免疫功能,但对代谢功能和预后的作用均有待进一步分析。
Objective To investigate the effect of thymosin α1 on immunity, metabolism and prognosis in elderly patients with sepsis followed by persistent inflammation, immunosuppression, and catabolism syndrome （PICS）. Methods In this retrospective study, 68 patients diagnosed with sepsis followed by PICS in medical in- tensive care unit （MICU） from Jan.2014 to Dee.2016 were involved. Thirty-four patients treated with thymosin α1 for 2 weeks were allotted to the observational group; other 34 patients were to the control group. Patients＇ clinical information and data of laboratory test were collected in addition. We compared patients＇ general information, and the indexes before and after treatment, then the indexes between the two groups to analyze the effect of thymosin α1 on immunity and metabolism ; moreover, we conducted survival analysis and compared the mortality of different periods to analyze the effect of thymosin α1 on prognosis. Results The number of monocytes, the levels of CD4/ CD8 and HLADR/CD14 before and after treatment in the observational group were significantly higher than those in the control group [ （0.11 ±0.31 ）x 109/L vs. （-0.16± 0.36）×10^9/L, （0.20 ± 0.94） vs. （-0.22 ± 0.74） and （5.8 ± 16.3 ）% vs. （-3.3 ± 18.2）% respectively ] , which suggested that the number of monocytes and the levels of CD4/ CD8 and HLADR/CD14 were significantly increased by thymosin etl intervention, and the difference were statistically significant （P 〈 0.05）. Kaplan-meier survival analysis showed prognosis between the two groups was not statis- tically significant （P 〉 0.05 ）. The further analysis of mortality in different periods indicated that the mortality with- in 28 days, 90 days and 120 days and overall mortality between the two groups [8 （23.5%） vs. 12 （35.3%）, 18（52.9%） vs. 25（73.5%）, 20（58.8%） vs. 27（79.4%） and 24（70.6%） vs. 28（82.4%） respectively], were not sta- tistically significant （P 〉 0.05）. Conclusions Thymosin a 1
出处
《实用医学杂志》
CAS
北大核心
2018年第1期119-123,共5页
The Journal of Practical Medicine
基金
广东省科技计划项目(编号：2012A061400010)
广州市科技计划项目(编号：20150820253)
广州市科研条件建设项目(编号：7411675081103)
广州市科学研究专项(编号：2014J4100033)
