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对重庆医科大学附属第一医院和浙江医科大学第一附属医院2003年至今的31例肝移植患者移植后巨细胞病毒感染性肺炎进行回顾性分析,根据是否使用胸腺肽αl随机分为2组:对照组14例,胸腺肽αl治疗组17例。2组的临床基线资料无显著差别。在巨细胞病毒感染性肺炎诊断成立时2组患者立即撤减免疫抑制剂,停用他克莫斯,西罗莫斯和泼尼松减半。胸腺肽αl治疗组加用胸腺肽αl,1次/d,1.6mg/次肌肉注射,共用14d。胸腺肽αl治疗的患者1周和2周时分别检测如下指标:外周血CD4+、CD8+淋巴细胞计数、CD4+/CD8+比值、外周血白细胞记数、抢救成功率、有无急性排斥反应,比较两组各项检查指标有无统计学意义,从而探讨Tsαl治疗巨细胞病毒感染性肺炎的临床意义。与对照组比较,胸腺肽αl治疗1周和2周的CD4+和CD8+淋巴细胞、CD4+/CD8+比值和外周白细胞计数明显高于对照组(P<0.01),抢救成功率也高于对照组(P<0.05)。胸腺肽αl治疗组2例和对照组1例分别出现急性排斥反应,经甲泼尼龙冲击治疗后很快好转。实验结果提示加用胸腺肽αl、撤减免疫抑制剂治疗肝移植后并发巨细胞病毒感染性肺炎有较好疗效,进一步说明胸腺肽αl可以调节T淋巴细胞数量,提高免疫功能,增强抗感染能力。
Thirty-one cases of cytomegalovirus-infected pneumonia after transplantation in the first affiliated hospital of Chongqing Medical University and the First Affiliated Hospital of Zhejiang Medical University from 2003 to the present were retrospectively analyzed, and were randomly divided into two groups according to whether the thymosin αl was used: Group 14 cases, thymosin αl treatment group 17 cases. There was no significant difference between the two groups in clinical baseline data. In the diagnosis of cytomegalovirus pneumonia established two groups of patients immediately immunosuppressant withdrawal, deactivation of tacrolimus, sirolimus and prednisone by half. Thymosin αl treatment group with thymosin αl, 1 / d, 1.6mg / intramuscular injection, shared 14d. Thymosin αl treatment of patients at 1 week and 2 weeks when the following indicators were measured: peripheral blood CD4 +, CD8 lymphocyte count, CD4 / CD8 ratio, peripheral blood leukocyte count, rescue success rate, with or without acute rejection, the two groups each Item inspection index was statistically significant, so as to explore the clinical significance of Tsal in the treatment of cytomegalovirus infectious pneumonia. Compared with the control group, the ratio of CD4 + / CD8 + and peripheral leukocyte counts in thymosin α1 group at 1 and 2 weeks after treatment were significantly higher than those in control group (P <0.01), and the successful rescue rate was also higher than that in control group (P < 0.05). Thymosin αl treatment group 2 patients and control group 1 patients were acute rejection, the impact of methylprednisolone therapy soon improved. Experimental results suggest that the addition of thymosin αl, the withdrawal of immunosuppressive agents in the treatment of cytomegalovirus infection after pneumonitis complicated with pneumonia have a better effect, further elucidation of thymosin αl can regulate the number of T lymphocytes, improve immune function and enhance anti-infective ability.