论文部分内容阅读
目的探讨卡介菌多糖核酸对慢性阻塞性肺疾病(COPD)患者体液免疫及外周血白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)的影响,为临床上评估该药治疗COPD的疗效提供理论依据。方法随机选择2012年3月-2013年2月在呼吸与危重症医学科住院的老年COPD急性加重期患者30例,同期门诊随诊的COPD稳定期患者60例,同期在体检中心体检健康人60例,健康人分为老年健康组(n=30)和非老年健康组(n=30),均为正常对照组。各组均测定IL-8、TNF-α、免疫球蛋白A(Ig A)、免疫球蛋白G(Ig G)、免疫球蛋白M(Ig M)含量。COPD稳定期患者再随机分成2组:A组30例,B组30例。COPD B组除常规治疗外加用卡介菌多糖核酸0.35 mg/d,肌肉注射,3次/周;COPD A组只接受稳定期常规治疗,两组患者均观察1个月,于治疗前后测定外周血IL-8、TNF-α、Ig A、Ig G、Ig M含量。结果老年健康组外周血IL-8、TNF-α与非老年健康组比较差异无统计学意义(P>0.05),但Ig A、Ig G、Ig M较非老年健康组降低(P<0.05)。COPD急性加重期组与稳定期组、老年健康组比较外周血Ig A、Ig G、Ig M下降(P<0.05),但IL-8、TNF-α升高(P>0.05)。COPD A组常规治疗前后外周血IL-8、TNF-α、Ig A、Ig G、Ig M均无明显变化,差异无统计学意义(P>0.05)。COPD B组使用卡介菌多糖核酸治疗后,外周血Ig A、Ig G、Ig M较治疗前及A组治疗前、后升高(P<0.05),而IL-8、TNF-α较治疗前及A组治疗前、后下降(P<0.05)。结论随着年龄的增长,健康人的体液免疫功能下降。老年COPD患者存在体液免疫功能异常,急性加重期更为显著。卡介菌多糖核酸可降低COPD稳定期患者外周血炎症因子含量,增强体液免疫功能。
Objective To investigate the effects of BCG-PSN on humoral immunity and peripheral blood interleukin-8 (IL-8), tumor necrosis factor-α (TNF-α) in patients with chronic obstructive pulmonary disease (COPD) The drug treatment of COPD provide the theoretical basis. Methods Thirty patients with acute exacerbation of COPD who were hospitalized in Department of Respiratory and Critical Care Medicine from March 2012 to February 2013 were selected randomly from 60 patients with stable COPD who were followed up during the same period. During the same period, 60 healthy people For example, healthy people were divided into geriatric health group (n = 30) and non-geriatric health group (n = 30), which were normal control group. The levels of IL-8, TNF-α, Ig A, Ig G and Ig M in each group were determined. Patients with stable COPD were randomly divided into two groups: A group of 30 cases, B group of 30 cases. In addition to conventional treatment, COPD group B received intraperitoneal injection of BCG 0.35 mg / d intramuscularly for 3 times a week. COPD group A received routine stable treatment only. Both groups were observed for 1 month. Peripheral cycles Blood IL-8, TNF-α, Ig A, Ig G, Ig M content. Results The levels of IL-8 and TNF-α in peripheral blood of elderly patients were not significantly different from those of non-elderly healthy people (P> 0.05), but Ig A, Ig G and Ig M were lower than those of non-elderly healthy people (P <0.05) . The levels of Ig A, Ig G and Ig M in peripheral blood of COPD acute exacerbation group were lower than those in stable group and elderly healthy group (P <0.05), but IL-8 and TNF-α increased (P> 0.05). The levels of IL-8, TNF-α, Ig A, Ig G and Ig M in peripheral blood of COPD group A before and after conventional treatment showed no significant difference (P> 0.05). COPD group B using BCG polysaccharide nucleic acid therapy, the peripheral blood Ig A, Ig G, Ig M than before treatment and before treatment group A, before and after treatment (P <0.05), while IL-8, TNF-α than treatment Before and A group before and after treatment decreased (P <0.05). Conclusion With the increase of age, the humoral immune function of healthy people decreased. In elderly patients with COPD, there is abnormal humoral immunity, and the acute exacerbation is more significant. BCG polysaccharides nucleic acid can reduce peripheral blood inflammatory factor levels in patients with stable COPD, enhance humoral immune function.