长程预防用量白葡奈氏菌片对中重度COPD患者机体免疫功能及生活质量的影响

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摘要目的：探讨长程预防用量白葡奈氏菌片对中重度慢性阻塞性肺疾病（COPD）患者机体免疫功能及生活质量的影响。方法：选取2016年1月至2017年1月在衢州市人民医院就诊的中重度COPD患者60例，随机分成治疗组及基础组，每组30例。治疗组在基础组常规治疗基础上加用白葡奈氏菌片（2片/次，2次/d，口服），疗程3个月。治疗结束后对2组患者机体免疫情况、生活质量情况进行比较分析。同时统计患者用药前后各1年内急性加重次数。选取同期健康体检者30例作为健康对照组。结果：治疗前，与健康对照组比较，治疗组和基础组患者CD3+、CD4+、CD4+/CD8+、NK细胞、B细胞、IgG、IgA、IgM降低，CD8+、医院焦虑抑郁量表（HAD）评分升高（P＜0.05），治疗组和基础组间各指标比较差异无统计学意义（P＞0.05）。治疗组患者服用白葡奈氏菌片期间均无明显不适，与治疗前比较，治疗后CD3+、CD4+、CD4+/CD8+、B细胞、NK细胞、IgG、IgA、第一秒用力呼气容积（FEV1）升高（P＜0.05），CD8+、COPD评估测试、改良英国医学研究学会呼吸困难指数（mMRC）、HAD评分下降（P＜0.05），年急性加重次数减少（P＜0.05），IgM在治疗前后差异无统计学意义（P＞0.05），上呼吸道感染的例数及上呼吸道感染症状持续的时间明显少于基础组（P＜0.05）。基础组治疗前后各指标变化差异无统计学意义（P＞0.05）。结论：中重度COPD患者存在机体免疫功能下降，长程预防用量白葡奈氏菌片治疗对中重度COPD患者是安全有效的，可提高机体免疫功能及减少呼吸道症状，改善患者生活质量。

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关键词 ：肺疾病, 慢性阻塞性, 白葡奈氏菌片, 长程, 免疫功能, 生活质量

Abstract：Objective: To explore the effects of long-term prophylactic dose of Staphylococcus and Neisseria Tablets on immune function and life quality in patients with moderately severe COPD patients. Methods: Sixty patients with moderately severe COPD admitted to People’s Hospital of Quzhou between January 2016 to January 2017 were randomly divided into treatment group (n=30) and basic group (n=30). The treatment group was prescribed with Staphylococcus and Neisseria Tablets (two tablets twice daily, oral) for 3 months on the basis of routine treatment, while the basic group was given routine treatment only. After 3 months of treatment, analysis was made to compare the immune function and the life quality of these groups. The number of exacerbations was counted before and after treatment for 1 year. Meanwhile, 30 healthy people who came to our hospital for physical checkup in the same period were selected as healthy controls. Results: Compared with the control group, both the treatment group and the basic group had decreased levels of COPD CD3+, CD4+, CD4+/CD8+, NK cells, B cells, IgG, lgA, lgM, and increased levels of CD8+, HAD (P<0.05). The immune indices of the treatment group and the basic group did not show any significant difference (P>0.05). Patients in the treatment group did not report any obvious discomfort during the course of treatment. After the treatment, CD3+, CD4+, CD4+/CD8+, NK cells, B cells, IgG, lgA, FEV1 had increased, while CD8+, CAT, mMRC, HAD and the number of exacerbationshad decreased significantly (P<0.05). There was no significant difference in the level of IgM before and after treatment (P>0.05). Compared with the basic group, the frequency of upper respiratory tract infection and duration of the symptoms were significantly less in the treatment group (P<0.05). No obvious changes had been found in the indices of the basic group before and after treatment (P>0.05). Conclusion: The body’s immune function had declined in patients with moderately severe COPD. Long-term prophylactic dose of Staphylococcus and Neisseria Tablets was safe and effective, which can enhance the body’s immune function, reduce respiratory symptoms and improve life quality of the patients with moderately severe COPD.

Key words： pulmonary diseases, chronic obstructive Staphylococcus and Neisseria Tablets long-term immune function life quality

收稿日期: 2018-01-15

基金资助:衢州市科技局科技项目（2015064，2015065）。

作者简介: 刘贤兵（1983-），男，浙江江山人，副主任医师，硕士。

链接本文:

https://xb.wmu.edu.cn/CN/ 或 https://xb.wmu.edu.cn/CN/Y2018/V48/I9/676

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