Clinical Observation Of Thymosin Alpha 1 In The Treatment Of Patients With Community Acquired Pneumonia

Objective: In this study,thymosin alpha 1 was used in the treatment of patients with community acquired pneumonia.To observe the effect of the drug on patients with T lymphocyte subsets and white blood cell count,neutrophil / lymphocyte ratio C,C-reactive protein and procalcitonin levels,to explore the immunomodulatory therapy for influencing the prognosis of patients with pneumonia and its clinical significance to the community,provide valuable theoretical basis for clinical treatment.Methods: The study was conducted on 41 cases of community acquired pneumonia in the respiratory department of Southwest Medical University from September 2017 to January 2018.All the 41 patients included in the experiment met the diagnostic criteria of the guideline for diagnosis and treatment of community acquired pneumonia,formulated by the respiratory medicine branch of Chinese Medical Association in2016.The patients were randomly divided into 21 patients in the treatment group and 20 in the control group.The control group was treated with conventional treatment(Anti-infective,expectorant,antispasmodic,maintain water electrolyte balance and other symptomatic treatment),while patients in the treatment group,in addition to the conventional treatment,were additionally given a subcutaneous injection of thymosin alpha 1 which was operated twice a week.The two groups' peripheral blood T lymphocyte subsets,white blood cell count(WBC),neutrophil count,lymphocyte count before and after the treatment,as well as the Neutrophil-lymphocyte count ratio were compared.Meanwhile,changes of c-reactive protein(CRP),procalcitonin(PCT)level of patients in two groups were noted.Other clinical outcomes such as pulmonary infection control window(PIC-Window),total treatment efficiency,mortality,etc,were also evaluated.Results: 1.Phenotypic changes of T lymphocyte: Before the treatment,control group CD3+(66.72 + 3.15)%,CD4+(36.99 + 2.21)%,CD8+(28.84 + 3.85)%,CD4+/ CD8+(1.35 + 0.26),CD3+ group and Thymosin alpha 1(66.77 + 4.34)%,CD4+(35.46 + 2.98)%,CD8+(28.69 + 7.36)%CD4+/,CD8+(1.26 + 0.19)there was no significant difference in T lymphocyte phenotype(P > 0.05).After 1 weeks of treatment,thymosin alpha 1 group CD3+(76.06 + 5.49)%,CD4+(46.99 + 6.01%),CD4+/CD8+(1.95 + 0.43)immune indexes were significantly increased,CD8+(24.72 + 3.98)% immune index decreased,suggesting that the immune index improved significantly,the results were statistically significant(P <0.05).While the control group after treatment,CD3+(70.93 + 4.63)%,CD4+(340.64 + 2.63)%,CD8+(27.16 + 3.42)%,CD4+/ CD8+(1.52 +0.21)changes of the immune index with thymosin alpha 1 group,the difference was statistically significant(P < 0.05),the improvement of thymosin alpha 1 group T lymph cell immune index and after treatment is more obvious,the difference was statistically significant(P < 0.05).2.Change of infection index: Before treatment,the control group of white blood cell count(11.78 + 5.28)x109,NLCR(13.49 + 10.25),C reactive protein(55.38 + 17.86)mg/l,procalcitonin(1.16 + 0.94)ng/ml and Thymosin alpha 1 group of white blood cell count(10.21 + 5.28)x109,NLCR(12.55 + 9.56),C reactive protein(59.84 + 22.47)mg/l,procalcitonin(1.11 + 1.09)no significant difference between the two groups of ng/ml levels(P > 0.05).After 1 weeks of treatment,the control group of white blood cell count(9.50 + 4.40)x109,NLCR(7.27 + 5.83),C reactive protein(13.19 + 12.46)mg/l,procalcitonin(0.27 + 0.37)ng/ml decreased than before,including NLCR,C reactive protein,procalcitonin was statistically significant(P < 0.05),and after treatment of thymosin alpha 1 group NLCR(4.13 + 3.63),C reactive protein(6.11 + 8.37)mg/l,procalcitonin(0.07 + 0.21)improved more significantly,the difference was statistically significant(P < 0.05).3.Observation of clinical effect: Thymosin alpha 1 group of patients after treatment,the average such confinement,total effective rate of treatment,and case fatality rate,respectively,85.7%,4.7%(7.7 + 1.0)days,are better than that of control group(8.6 + 1.3)days,75.0%,5.0%,the average such confinement and total effective rate was statistically significant(P < 0.05).Conclusion: 1 ? Patients with community-acquired pneumonia had impaired immune function,which could be manifested as CD3+ and CD4+T lymphocytes decreased,while CD8+T lymphocytes increased,CD4+/CD8+ decreased,neutrophil / lymphocyte ratio,C reactive protein and procalcitonin level increased.It is necessary to detect the index of T lymphocyte subsets,so as to understand the immune status of the body,identify whether the immune function is damaged and its degree,so as to provide help for clinical targeted treatment.2?The use of thymosin alpha 1 subcutaneous injection can better improve the cellular immune function of the patients,the increase of CD3+ and CD4+T lymphocytes increased CD4+/CD8+,reduced NLCR,C reactive protein and procalcitonin level,restored immune function and relieved systemic inflammatory response,thereby improving the condition,shortening the average hospitalization time and improving the effective rate.It is expected that further multicenter,large sample prospective studies will continue to explore the immunotherapy of community-acquired pneumonia and its possible mechanisms.