内科

目的探讨胸腺肽α1治疗老年2型糖尿病合并重症肺炎患者的效果及对免疫功能的影响。方法选择在我院治疗的老年2型糖尿病合并重症肺炎患者84例，随机分为对照组和观察组，每组42例。对照组患者进行降血糖、抗感染等常规治疗；观察组患者在常规治疗的基础上应用胸腺肽α1治疗。比较两组患者的治疗效果和免疫功能状态。结果观察组患者感染控制窗出现时间短于对照组、APACHEⅡ评分均低于对照组，差异有统计学意义(P＜0.01)；两组患者的机械通气率、住院死亡率比较差异无统计学意义（P＞0.05）。治疗1个疗程后，观察组患者CD3+ 、CD4+ 、CD4+ /CD8+ 和NK细胞活性均高于治疗前， CD8+ 低于治疗前，差异有统计学意义(P＜0.01)；观察组患者CD3+ 、CD4+ 、NK细胞活性均高于对照组 (P＜0.01)，CD8+ 低于对照组，差异有统计学意义(P＜0.01)；观察组患者血清IgG、IgM和C3含量均高于治疗前，IgE和TNF-α含量低于治疗前，差异有统计学意义(P＜0.01)；观察组患者血清IgG、IgM和C3含量均高于对照组， IgE和TNF-α含量均低于对照组，差异有统计学意义(P＜0.01)。结论应用胸腺肽α1辅助治疗老年2型糖尿病合并重症肺炎患者，能够有效改善患者的免疫功能状态，提高治疗效果，改善患者预后。

ObjectiveTo investigate the effect of thymosin alpha 1 in the treatment of elderly patients with type 2 diabetes combined with severe pneumonia and its effect on immune function. Methods84 elderly patients with type 2 diabetes combined with severe pneumonia in our hospital were randomly divided into the control group and the observation group, with 42 cases in each group. The control group were treated with routine treatment, such as hypoglycemic and anti infection. The observation group was treated with thymosin alpha 1 on the basis of routine treatment. The therapeutic effect and immune function status of the two groups were compared. ResultsThe time of infection control window in the observation group was shorter than that of the control group and the score of APACHE II was lower than the control group, the difference was statistically significant (P＜0.01). There was no significant difference in the rate of mechanical ventilation and hospitalization mortality between the two groups (P＞0.05). After 1 courses of treatment, the activities of CD3+ , CD4+ , CD4+ / CD8+ and NK cells in the observation group were all higher than those before treatment, and CD8+ was lower than before treatment, the difference was statistically significant (P＜0.01). The activity of CD3+ , CD4+ and NK cells in the observation group was higher than that of the control group (P＜0.01), and the CD8+ was lower than the control group, the difference was statistically significant (P＜0.01). The content of serum IgG, IgM and C3 in the observation group was higher than that before the treatment, and the content of IgE and TNF-alpha was lower than that before the treatment (P＜0.01). The content of serum IgG, IgM and C3 in the observation group was higher than that of the control group, and the content of IgE and TNF-alpha was lower than that of the control group, the difference was statistically significant (P＜0.01). ConclusionThymosin alpha 1 in the treatment of elderly patients with type 2 diabetes and severe pneumonia can effectively improve the immune function of patients, improve the treatment effect and improve the prognosis of patients.