目的：探讨胸腺肽α1治疗老年慢性阻塞性肺疾病(COPD)的效果及其对血清脂联素和炎症因子的影响。方法选取2010年3月~2014年2月崇州市人民医院呼吸内科门诊及住院诊治的82例稳定期COPD患者为研究对象，以随机数字表法将其分为对照组和观察组，每组各41例。两组患者均给予止咳、化痰、平喘、氧疗等常规综合治疗措施，治疗组患者在此基础之上给予1.6 mg胸腺肽α1皮下注射治疗，每隔1 d 1次，疗程持续2周。对比观察两组患者的生活质量和COPD评估测试(CAT)评分、肺功能、血气分析指标及其脂联素和炎症因子的变化。结果治疗前两组患者生活质量症状、活动和影响维度评分、呼吸困难分级和CAT评分、肺功能和血气分析指标、炎症因子和脂联素水平比较差异均无统计学意义(P跃0.05)；治疗后，白细胞介素(IL)-6、IL-8、肿瘤坏死因子α(TNF-α)和脂联素的水平均显著下降(P约0.01)；肺功能和血气分析指标第1秒用力呼气容积(FEV1)、第1秒用力呼气容积占预计值的百分比(FEV1%pre)、FEV1/用力肺活量(FVC)、动脉氧分压(PaO2)和动脉血二氧化碳分压(PaCO2)均较治疗前显著改善(P约0.01)；而且，呼吸困难分级和CAT评分值、生活质量评分均得到显著改善(P约0.05或P约0.01)；且观察组患者上述各项指标的变化幅度明显优于对照组(P约0.05)。结论胸腺肽α1能够显著降低炎症因子和脂联素水平，改善肺功能，并提高老年COPD患者的生活质量。%Objective To explore the clinical efficacy of thymosin α1 on elderly patients with chronic obstructive pul-monary disease and its influence on serum adiponectin and inflammatory factors. Methods 82 patients with stable COPD in Department of Respiratory Medicine of People's Hospital of Chongzhou City from March 2010 to February 2014 were selected as the research object. They were randomly divided into control group and observation group ac-cording to the different treatments, with 41 cases in each group. Both groups were given a cough, phlegm, relieving asthma, oxygen therapy and other routine comprehensive treatments, but the patients in the treatment group were also received 1.6 mg subcutaneous injection of thymosin α1, every 2 days for 1 time and the course of treatment lasted for two weeks. Changes on quality of life and CAT score, pulmonary function, blood gas analysis index and adiponectin and inflammatory factors were compared between the two groups. Results The quality of life in patients with symptoms, ac-tivities and influence of dimension score, dyspnea scale and CAT score, lung function and blood gas analysis index, in-flammatory factors and adiponectin levels showed no significant differences before treatment in two groups (P> 0.05);after treatment, levels of IL-6, IL-8, TNF-αand adiponectin were significantly decreased (P<0.01); lung function and blood gas analysis indexes of FEV1, FEV1%pre, FEV1/FVC, PaO2 and PaCO2 were significantly improved (P < 0.01);moreover, dyspnea scale and CAT score, quality of life score showed significant improvements (P< 0.05 or P< 0.01);moreover, the amplitude of variation of above indicators in the observation group were better than those of control group (P< 0.05). Conclusion Thymosin α1 can significantly reduce inflammatory factors and adiponectin levels, improve pul-monary function, and improve the quality of life of elderly patients with COPD.
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