目的 探討胸腺五肽聯(lián)合布地格福吸入氣霧劑治療Ⅲ、Ⅳ級慢性阻塞性肺疾?。–OPD）穩(wěn)定期的臨床療效。方法 選取新疆醫(yī)科大學(xué)第六附屬醫(yī)院于2021年6月—2023年6月收治Ⅲ、Ⅳ級COPD穩(wěn)定期患者150例，隨機(jī)分為對照組（75例）和治療組（75例）。對照組吸入布地格福吸入氣霧劑，2吸/次，2次/d。治療組在對照組基礎(chǔ)上皮下注射注射用胸腺五肽，10 mg/次，2次/周。兩組患者均治療3個(gè)月。觀察兩組患者臨床療效，比較治療前后兩組患者肺功能指標(biāo)第1秒用力呼氣容積（FEV1）/用力肺活量（FVC）、FEV1占預(yù)計(jì)值百分比（FEV1%）和殘氣容積/肺總量（RV/TLC）水平，免疫功能指標(biāo)CD3^＋、CD4^＋和CD4^＋/CD8^＋水平，氣道黏液高分泌指標(biāo)痰液干/濕質(zhì)量比和黏蛋白5AC（MUC5AC）水平，及預(yù)后情況。結(jié)果 治療后，治療組總有效率明顯高于對照組（94.67% vs 82.67%，P＜0.05）。治療后，兩組患者FEV1/FVC、FEV1%、CD3^＋、CD4^＋、CD4^＋/CD8^＋水平比治療前均明顯升高，而RV/TLC、痰液干/濕質(zhì)量比、MUC5AC水平明顯降低（P＜0.05），且治療組這些肺功能、免疫功能和氣道黏液高分泌指標(biāo)明顯好于對照組（P＜0.05）。治療后，治療組COPD急性加重次數(shù)及再住院率明顯低于對照組（P＜0.05）。結(jié)論 胸腺五肽聯(lián)合布地格福吸入氣霧劑治療Ⅲ、Ⅳ級COPD穩(wěn)定期患者，可調(diào)節(jié)免疫功能，緩解氣道黏液高分泌狀態(tài)，改善肺功能，提高臨床療效，從而進(jìn)一步改善預(yù)后。

Objective To investigate the clinical efficacy of thymus pentapeptide combined with thymopentin in treatment of stable stage of grade Ⅲ and Ⅳ chronic obstructive pulmonary disease. Methods Patients (150 cases) with stable stage of grade Ⅲ and Ⅳ chronic obstructive pulmonary disease in the Sixth Affiliated Hospital of Xinjiang Medical University from June 2021 to June 2023 were randomly divided into control (75 cases) and treatment (75 cases) group. Patients in the control group were inhaled with Budesonide, Glycopyrronium Bromide and Formoterol Fumarate Inhalation Aerosol, 2 puffs/time, twice daily. Patients in the treatment group were subcutaneous injection administered with Thymopentin for injection, 10 mg/time, twice weekly. Patients in two groups were treated for 3 months. After treatment, the clinical evaluations were evaluated, the levels of lung function indexes FEV1/FVC, FEV1% and RV/TLC, the levels of immune function indexes CD3^＋, CD4^＋ and CD4^＋/CD8^＋, the levels of airway mucus hypersecretion indexes dry/wet density of sputum and MUC5AC, and the prognosis in two groups before and after treatment were compared. Results After treatment, the total effective rate in the treatment group was significantly higher than that in the control group (94.67% vs 82.67%, P < 0.05). After treatment, the levels of FEV1/FVC, FEV1%, CD3^＋, CD4^＋, and CD4^＋/CD8^＋ in two groups were significantly higher than before treatment, while the levels of RV/TLC, dry/wet sputum specific gravity, and MUC5AC were significantly lower (P < 0.05). After treatment, these indicators of lung function, immune function and airway mucus hypersecretion in the treatment group were significantly better than those in the control group (P < 0.05). After treatment, the number of COPD exacerbations and the re-hospitalization rate in the treatment group were significantly lower than those in the control group (P < 0.05). Conclusion Thymopentin combined with Budesonide, Glycopyrronium Bromide and Formoterol Fumarate Inhalation Aerosol can regulate immune function, relieve airway mucus hypersecretion, improve lung function, improve clinical efficacy, and further improve prognosis in stable COPD patients with grade Ⅲ and Ⅳ.

R974

新疆維吾爾自治區(qū)藥學(xué)會科研基金項(xiàng)目（YXH2022002）