目的 探讨胸腺五肽联合布地格福吸入气雾剂治疗Ⅲ、Ⅳ级慢性阻塞性肺疾病（COPD）稳定期的临床疗效。方法 选取新疆医科大学第六附属医院于2021年6月—2023年6月收治Ⅲ、Ⅳ级COPD稳定期患者150例，随机分为对照组（75例）和治疗组（75例）。对照组吸入布地格福吸入气雾剂，2吸/次，2次/d。治疗组在对照组基础上皮下注射注射用胸腺五肽，10 mg/次，2次/周。两组患者均治疗3个月。观察两组患者临床疗效，比较治疗前后两组患者肺功能指标第1秒用力呼气容积（FEV1）/用力肺活量（FVC）、FEV1占预计值百分比（FEV1%）和残气容积/肺总量（RV/TLC）水平，免疫功能指标CD3^＋、CD4^＋和CD4^＋/CD8^＋水平，气道黏液高分泌指标痰液干/湿质量比和黏蛋白5AC（MUC5AC）水平，及预后情况。结果 治疗后，治疗组总有效率明显高于对照组（94.67% vs 82.67%，P＜0.05）。治疗后，两组患者FEV1/FVC、FEV1%、CD3^＋、CD4^＋、CD4^＋/CD8^＋水平比治疗前均明显升高，而RV/TLC、痰液干/湿质量比、MUC5AC水平明显降低（P＜0.05），且治疗组这些肺功能、免疫功能和气道黏液高分泌指标明显好于对照组（P＜0.05）。治疗后，治疗组COPD急性加重次数及再住院率明显低于对照组（P＜0.05）。结论 胸腺五肽联合布地格福吸入气雾剂治疗Ⅲ、Ⅳ级COPD稳定期患者，可调节免疫功能，缓解气道黏液高分泌状态，改善肺功能，提高临床疗效，从而进一步改善预后。

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

新疆维吾尔自治区药学会科研基金项目（YXH2022002）