| Objective:Chronic obstructive pulmonary disease(COPD)is usually developed from chronic bronchitis.It can be said that it is a common chronic respiratory disease in clinic.The incidence of smoking in middle-aged and elderly patients was significantly increased.The continuous airflow limitation was one of the necessary conditions for the diagnosis of the disease.The condition was irreversible when the treatment improperly affected the patient's lung function,and with the progressive decline of pulmonary function,The symptoms of dyspnea of the patients are gradually aggravated,the severe cases can lose their ability to work,and the quality of daily life will be seriously reduced.This will not only bring great harm to the patients' physical and mental health,but also cause certain economic and psychological pressure on their families.And increase the social burden.How to effectively prevent AECOPD,reduce the number of hospital stay and delay the progress of the disease has become a major problem.Because of many factors,such as old age,malnutrition,smoking,infection and so on,the immune function of COPD patients is often lower than that of healthy people.Respiratory tract infection is recognized as one of the most important causes of AECOPD,which undoubtedly accelerates the progression of COPD patients.In recent years,due to the continuous maturation and improvement of virus detection technology,the related research has shown that AECOPD is an important factor which is the respiratory virus infection.Therefore,this study provides a new reference for the prevention and treatment of chronic obstructive pulmonary disease by improving the immune function of patients with COPD.Methods:From December 2015 to December 2016,collected 37 patients with COPD who were diagnosed in Department of Respiratory Medicine,the first affiliated Hospital of Wan Nan Medical College.After fully explaining the content,significance and related risks of this study,the research participants agreed and signed the informed consent to join the study voluntarily.All the selected patients had good therapeutic compliance,long-term home oxygen therapy combined with ICS LABA or LAMA long-term inhalation therapy,and can ensure regular monthly follow-up.Thymosin al(batch number:H20150545:Chengdu Diao Jiuhong Pharmaceutical Factory,used:1.6 mg,subcutaneously,twice a week)was added to the stable period and all contraindications were excluded.Total course of treatment 1 month,and combined influenza vaccine(batch number:Chinese medicine accurate word FL20150627 manufacturer:Shenzhen Sanofi-Pasteur Biological products Co.,Ltd.,use:0.5ml[adult form],intramuscular injection[select the deltoid muscle of the arm],only once inoculated,inoculated immediately after entering the group).Finally meet the requirements of this test,including 35 patients,The immunological indexes CD3+,CD4+,CD8+,CD4+/CD8+ were measured before and after entering the group,and the pulmonary function of the seat(lung function test system type:MasterScreen,manufacturer:CareFusion Germany 234GmbH)6 minutes walking test and AECOPD times within 1 year before and after entering the group.The data of times and days of hospitalization were compared and analyzed.Results:1.Before the patient entered the group,CD8+T lymphocyte ratio was 30.14±7.28(%),CD8+T lymphocyte ratio for the third month after treatment was 25.84±6.52(%);Before the patient entered the group,CD3+T lymphocyte ratio was 61.10±8.17(%),CD4+T lymphocyte ratio was 28.21±6.05(%),CD4+/CD8+ ratio was 1.13±0.30,the third month after treatment,CD3+T lymphocyte ratio was 69.93±9.67(%),CD4+T lymphocyte ratio was 39.96±7.50(%),CD4+/CD8+ ratio was 1.72±0.30,The results showed that the immune function of the patients was significantly improved after the treatment.,P<0.05.2.Before the patient entered the group,6-minute walk distance was:263.60±72.81m,the third month after treatment,6-minute walk distance was:331.22±84.76m,The results showed that the motor ability of the patients was improved,and there was a significant difference between them before treatment and before treatment.P<0.05.3.Within one year before admission and within one year after joining the group,the number of AECOPD were respectively 3.17±1.29 and 2.14±0.94,The number of hospitalizations were respectively 1.51±0.85 and 1.06±0.80,The number of days of hospitalizationwere respectively 13.06±5.66(d)and 9.06±3.58(d),It can be seen that with the improvement of immune function,the decrease of respiratory tract infection,the acute exacerbation of patients and the number of hospitalization due to acute aggravation,the course of hospitalization is also shortened obviously,the difference is statistically significant.P<0.05.4.The pulmonary function index of the patients before admission,FEV1(L)was 1.22 ±0.44,FVC(L)was 2.09±0.75,FEV1/FVC(%)ratio was 61.25±8.15.After 3 months of treatment,FEV1(L)was 1.42±0.42,FVC(L)was 2.29 ±0.71,FEV1/FVC(%)ratio was 64.77±7.98.Only FEV1 increased,as compared with that before admission,P<0.05,but FVC and FEV1/FVC did not significantly improve,P>0.05,there was no significant difference.Conclusion:1.After adding immunomodulation and influenza vaccination to COPD patients,the ability of resisting respiratory tract infection was greatly enhanced with the gradual recovery of immune function and the improvement of immunity.The frequency of AECOPD can be effectively prevented,the number of hospitalization is also relatively reduced,the course of hospitalization is shortened obviously,and the ability of daily activities is improved significantly.2.After adding immunomodulation and influenza vaccination to prevent infection in COPD patients,the results showed that the pulmonary function of COPD patients did not improve significantly,The reason may be that the sample size of the selected study is small,The follow-up time is still short,which needs a larger sample and longer clinical study and exploration. |
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