Effect of thymalfasin on the immune function and inflammatory response in patients with severe pneumonia

Objective To explore the clinical efficacy of thymalfasin on the immune function and inflammatory response in the treatment of patients with severe pneumonia. Methods From June 2015 to June 2018, 86 patients with severe pneumonia in the Hospital of Zhejiang Provincial General Team of Armed Police were enrolled in the study.According to different treatment methods, they were divided into control group and treatment group, with 43 cases in each group.The control group was treated with cefoperazone/sulbactam sodium on the basis of conventional treatment.The treatment group was treated with thymalfasin on the basis of the treatment of the control group.The expression of monocyte human leukocyte antigen-DR (mHLA-DR), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) levels were measured before and after treatment.At the same time, CD4+, CD8+, CD4+/CD8+ before and after treatment were examined in the two groups.The efficacy and bacterial clearance rate of the two groups were evaluated.The adverse reactions were recorded. Results After treatment, the levels of IL-6 and TNF-α in the two groups were significantly lower than those before treatment [treatment group: (44.9±11.8)ng/L, (42.9±13.1)ng/L vs. (86.5±27.9)ng/L, (79.6±28.6)ng/L, control group: (71.5±14.2)ng/L, (65.9±22.6)ng/L vs. (87.1±28.6)ng/L, (78.8±29.1)ng/L, t=9.005, 7.650, 3.203, 2.295, all P<0.05]. The expression level of mHLA-DR in the treatment group after treatment [(44.8±5.7)%] was significantly higher than that before treatment [(27.1±3.4)%, t=17.487, P=0.000]. The changes of the indicators in the treatment group were significantly better than those in the control group (t=9.447, 5.773, 8.725, all P<0.05). After treatment, the CD4+ level of the two groups were higher than those before treatment, and the CD8+ levels of the two groups were significantly lower than those before treatment, the differences were statistically significant(t=3.050, 3.429, 6.965, 13.327, all P<0.05), and the CD4+/CD8+ of the two groups were significantly increased (t=0.370, 3.314, all P<0.05). The indicators of the treatment group were improved more significantly than the control group (t=4.416, 12.355, 3.089, all P<0.05). The bacterial clearance rate of the treatment group was 88.89% (32/36), which was significantly higher than that of the control group [67.65% (23/34), χ2=4.686, P=0.030]. The clinical efficacy of the treatment group was 93.02%(40/43), which was significantly higher than 76.74%(33/43) of the control group (χ2=6.095, P=0.047). The incidence of adverse reactions between the two groups had no statistically significant difference (χ2=0.212, P=0.645). Conclusion Thymalfasin in the treatment of patients with severe pneumonia can improve the immune function, reduce the inflammatory response, improve the bacterial clearance rate and clinical efficacy, and will not increase the adverse reactions, so it is worthy of promoting. Key words: Pneumonia; Intensive care; CD4-positive T-pymphocytes; CD8-positive T-pymphocytes; Interleukin-6; Tumor necrosis factor-alpha; Cefoperazone/sulbactam sodium; Thymalfasin for injection