Abstract:

Objective　To investigate the therapeutic effect of thymic peptide α1 combined with biapenem in the treatment of severe pneumonia and its effects on serum CD40L, surfactant associated protein D (SP-D), and interleukin-1β (IL-1β) levels. Methods　In this prospective study, 88 patients with severe pneumonia admitted to Xi'an Fengcheng Hospital from June 2022 to August 2023 were selected as the research objects, and were divided into a study group and a control group according to the random number table method, with 44 cases in each group. In the control group, there were 24 males and 20 females, aged 40-69 (52.34±5.76) years, and the course of disease was 1-3 (2.10±0.24) weeks. In the study group, there were 23 males and 21 females, aged 41-65 (50.83±5.24) years, and the course of disease was 1-4 (2.57±0.84) weeks. The control group was given biapenem on the basis of conventional treatment (intravenous drip with 0.3 g diluted in 100 ml of normal saline, once every 8 h, 3 times a day). The study group was given thymic peptide α1 on the basis of the control group (1.6 mg thymic peptide α1 was dissolved in 1 ml of water for injection and then injected subcutaneously, once a day). Both groups were treated for 2 weeks. The effective rate of treatment, Acute Physiology and Chronic Health Evaluation Ⅱ (APACHEⅡ) score, and serum levels of CD40L, SP-D, and IL-1β were compared between the two groups. t test and χ² test were used for statistical analysis. Results　The effective rate of treatment in the study group was higher than that in the control group [84.91% (37/44) vs. 70.45% (31/44)], with a statistically significant difference (χ²=4.706, P<0.05). After treatment, the APACHEⅡ score and levels of CD40L, IL-1β, and SP-D in the study group were lower than those in the control group [(12.59±4.35) points vs. (15.40±4.61) points, (1.48±0.63) μg/L vs. (2.64±0.40) μg/L, (19.81±1.57) ng/L vs. (24.30±1.76) ng/L, (145.67±10.69) μg/L vs. (152.31±10.74) μg/L], with statistically significant differences (t=-2.943, -10.361, -12.653, and -2.912, all P<0.05). Conclusion　Thymic peptide α1 combined with biapenem can improve the therapeutic effect and clinical symptoms of severe pneumonia, and reduce serum CD40L, SP-D, and IL-1β levels.

Key words:

Severe pneumonia, Thymic peptide α1, Biapenem, Curative effect

摘要：

目的　探究胸腺肽α1联合比阿培南对重症肺炎患者的治疗效果及血清CD40L、表面活性蛋白（SP-D）、白细胞介素-1β（IL-1β）的影响。方法　采用前瞻性研究，选取2022年6月至2023年8月西安凤城医院收治的88例重症肺炎患者作为研究对象，根据随机数字表法分为研究组和对照组，各44例。对照组：男24例、女20例，年龄40～69（52.34±5.76）岁；病程1～3（2.10±0.24）周；在常规治疗基础上使用比阿培南（0.3 g+100 ml生理盐水稀释后静脉滴注，每8 h 1次，3次/d）。研究组：男23例、女21例，年龄41～65（50.83±5.24）岁；病程1～4（2.57±0.84）周；在对照组基础上使用胸腺肽α1（1.6 mg胸腺肽α1以1 ml注射用水溶解后皮下注射，每天1次）。两组患者均持续治疗2周。比较两组患者治疗有效率，治疗前后急性生理学和慢性健康状况评价Ⅱ（APACHEⅡ）评分，以及血清CD40L、SP-D、IL-1β水平。统计学方法采用t检验、χ²检验。结果　研究组治疗有效率高于对照组［84.91%（37/44）比70.45%（31/44）］，差异有统计学意义（χ²=4.706，P<0.05）。治疗后，研究组APACHEⅡ评分和CD40L、IL-1β、SP-D水平均低于对照组［（12.59±4.35）分比（15.40±4.61）分、（1.48±0.63）μg/L比（2.64±0.40）μg/L、（19.81±1.57）ng/L比（24.30±1.76）ng/L、（145.67±10.69）μg/L比（152.31±10.74）μg/L］，差异均有统计学意义（t=-2.943、-10.361、-12.653、-2.912，均P<0.05）。结论　胸腺肽α1联合比阿培南能提高重症肺炎患者治疗效果，改善临床症状，降低血清CD40L、SP-D、IL-1β水平。

关键词:

重症肺炎, 胸腺肽α1, 比阿培南, 疗效