Effect Of Immunomodulatory Therapy On Immune Function And Clinical Efficacy In Elderly Patients With Severe Pneumonia

Objective:To investigate the effects of immunomodulators on the immune function and clinical efficacy of elderly patients with severe pneumonia;to compare the efficacy of recombinant human granulocyte stimulating factor and thymosin in the treatment of senile severe pneumonia.Methods:90 elderly patients with severe pneumonia who were hospitalized in our Hospital from January 2018 to September 2019 were selected.According to the random number table method,they were divided into group A,group B and group C,with 30 cases in each group.Group C was given conventional treatments such as antibiotics,expectorant,asthma,and oxygen therapy.Group A was given subcutaneous injection of recombinant human granulocyte stimulating factor?1ug/kg/d?for 7 days on the basis of conventional treatment.Group B was given intravenous injection of thymosin?40mg/time,once/day?for 7 days on the basis of conventional treatment.The clinical data of 3 groups of patients before and after treatment were collected and statistically analyzed.Results:1.Comparison of serum immune function-related indicators of patients in each groupThere was a significant difference in the serum IgA,IgM,IgG,CD₄⁺/CD₈⁺between the three groups after treatment compared with that before the treatment in the same group?P<0.05?.The serum of IgA,IgM,IgG,CD₄⁺/CD₈⁺in group A and group B were significantly higher than those in group C after treatment?P<0.05?.There was no significant difference in serum IgA,IgM,IgG,CD₄⁺/CD₈⁺after treatment between groups A and B?P>0.05?.2.Comparison of serum cytokine levels in each group of patientsThere was a significant difference in serum TNF-?,IL-6,CRP,and PCT between the three groups after treatment compared with that before the treatment in the same group?P<0.05?.The serum levels of TNF-?,IL-6,CRP,and PCT in group A and group B were significantly lower than those in group C after treatment?P<0.05?.There was no significant difference in serum TNF-?,IL-6,CRP,and PCT after treatment between groups A and B?P>0.05?.3.Comparison of APACHE?scores of patients in each groupThere was a significant difference in the APACHE?scores between the three groups after treatment compared with that before the treatment in the same group?P<0.05?.The APACHE?scores in group A and group B were significantly lower than those in group C after treatment?P<0.05?.There was no significant difference in the APACHE?scores after treatment between groups A and B?P>0.05?.4.Comparison of clinical effectiveness of patients in each group after treatmentThere was no significant difference in clinical effectiveness between the three groups after treatment?P>0.05?.5.Comparison of patients'probability of on-line and off-line rate after 7 days of treatmentThere was no significant difference in the probability of on-line between the three groups during the treatment?P>0.05?.After 7 days of treatment,the offline rate of group A and group B was higher than that of group C?P<0.05?.There was no significant difference in the off-line rate between group A and group B after treatment?P>0.05?.6.Comparison of the incidence of adverse reactions among patients in each groupThere was no significant difference in the incidence of adverse reactions between the three groups after treatment?P>0.05?.Conclusion:1.The use of recombinant human granulocyte stimulating factor or thymosin on the basis of conventional treatment can effectively improve the clinical efficacy and improve the prognosis of elderly patients with severe pneumonia without increasing the incidence of adverse reactions.2.Recombinant human granulocyte stimulating factor or thymosin therapy was used in the treatment of senile severe pneumonia,and no significant difference was found in clinical efficacy and prognosis.