胸腺五肽对产科危重症患者免疫调理治疗的随机对照研究

目的：研究产科危重病人CD3^＋、CD4^＋，CD8^＋、NK细胞记数、CD4^＋／CD8^＋、α白细胞介紊-6（IL-6）和肿瘤坏死因子α（TNF—α）的变化，探讨胸腺五肽（Thymopentin，TP-5）对产科重症病人的免疫调理作用。方法．2005年1月至2007年12月71例收住重庆医科大学附属第一医院中心ICU的产科重症病人随机分为对照组和治疗组，两组分别于治疗后1、5、10d检测CD3^＋、CD4^＋、CD8^＋和NK细胞数；于治疗前和治疗后1、5d测定病人血清IL-6和TNF—α的动态变化。结果：TP-5免疫调理治疗后两组病人T淋巴细胞总数和亚群在第5d开始有显著性差异，治疗组CD8^＋低于对照组，CD4^＋、NK细胞和CD4^＋／CD8^＋比值高于对照组（P〈0．05）。第10d治疗组CD3^＋、CD4^＋、NK细胞和CD4^＋／CD8^＋比值高于对照组，CD8^＋细胞低于对照组（P〈0．05）。治疗组血清IL-6在第5d下降（P〈0．05）。TNF—α在第1d开始低于对照组（P〈0．03），下降在第5d显著下降（P〈0．05）。结论：TP-5能明显调节产科危重病人免疫功能，使之趋于平衡，并最终获得改善预后的效果。且副反应少，可作为良好免疫调节剂用于产科危重病人综合治疗。

Effects of immunoregulation therapy with thymopentin on obstetrics patients with critical illness

Objective： To investigate the immune function with levels of CD3^＋, CD4^＋ , CD8^＋, NK, CD4^＋/CD8^＋, interleukin - 6 （ IL - 6） and TNF - α（ Tumor Necrosis Factor - α）of critical patients of obstetrics and to explore the effect d immunoregulation therapy with thymopeatin on these patients. Methods： 71critically illness patients were randomly divided into the control group and treatment group. Levels of CD3^＋, CD4^＋, CD8^＋, NK, CD4^＋/CD8^＋ were analyzed before the treatment and then analyzed again after 1.5 ＆ 10days of treatment. Levels of IL - 6 and TNF - α were analyzed before the treatment and then analyzed again after 1.5 days of treatment. Data were expressed as mean 4 ± standard and analyzed by using Analysis of Variance and correlation and linear regression. A P value less than 0.05 was regarded as statistically significance in all the tests conducted in this study. Results： Compared with the control group, the total lymphocyte count and subgroup of treatment began to have significant difference after 5 days of immunoregulation therapy with thymopentin （P 〈0.05）. The counts of CD4^＋ ,NK and CD4^＋/CD8^＋ of the treatment group were higher than the counts of control group（P 〈 0.05 ）. After 10 days of treatment, The counts of CD3^＋ , CD4^＋ NK and CD4^＋ / CD8^＋ of the treatment group were higher than the counts of control group（ P 〈 0. 05 ）. And the count of CD8^＋ of the treatment group was lower than the count of control group（ P 〈0.05）. The serum levels of L-6 of treatment group after 5 days of treatment was significantly decreased comparing with the level of control group（P 〈0.05）. The TNF - α level of treatment group began to decrease after 1 days of treatment, and it was decreased significantly after 5 days tonging with the level of the control treatment group（P 〈 0.05） .Conclusion： Thymopentin regulates the immune function of obstetrics patients with critical illness. It could reduce the fatality and the rate of se