目的 探讨脾多肽联合亚胺培南治疗老年重症肺部感染的临床安全性与有效性。方法 选择2016年3月—2018年3月在成都市西区医院治疗的老年重症肺部感染患者120例，随机分成对照组和治疗组，每组各60例。对照组患者静脉滴注注射用亚胺培南西司他丁钠，1.0 g加入250 mL生理盐水，2次/d；治疗组患者在对照组基础上静脉滴注脾多肽注射液，10 mL加入250 mL生理盐水，1次/d。两组患者均连续治疗14 d。观察两组患者临床疗效，同时比较治疗前后两组患者免疫因子水平、APACHEⅡ评分、MEWS评分、血清血红蛋白、降钙素原及和肽素水平。结果 治疗后，对照组临床有效率为81.67%，显著低于治疗组的95.00%，两组比较差异具有统计学意义（P<0.05）。治疗后，两组患者血清CD3⁺和CD4⁺水平均显著升高（P<0.05），且治疗组CD3⁺和CD4⁺水平明显高于对照组（P<0.05）。治疗后，两组患者APACHE Ⅱ和MEWS评分均显著降低（P<0.05），且治疗组APACHEⅡ和MEWS评分明显低于对照组（P<0.05）。治疗后，两组患者血清血红蛋白显著升高（P<0.05），降钙素原及和肽素水平显著降低（P<0.05），且治疗组血清血红蛋白、降钙素原及和肽素水平明显好于对照组（P<0.05）。结论 脾多肽联合亚胺培南治老年重症肺部感染疗效显著，安全性高，能够显著改善患者的免疫功能，具有一定的临床推广应用价值。

Objective To investigate the clinical safety and efficacy of Lienal Polypeptide Injection combined with imipenem in treatment of severe pulmonary infection in the elderly. Methods Patients (120 cases) with severe pulmonary infection in Chengdu Western Hospital from March 2016 to March 2018 were randomly divided into control (60 cases) and treatment (60 cases) groups. Patients in the control group were iv administered with Imipenem and Cilastatin Sodium for injection, 1 g added into 250 mL normal saline, twice daily. Patients in the treatment group were iv administered with Lienal Polypeptide Injection on the basis of the control group, 10 mL added into 250 mL normal saline, once daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacy was evaluated, and the immune factors levels, APACHE Ⅱand MEWS scores, serum hemoglobin, procalcitonin and copeptin levels in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 81.67%, which was significantly lower than 95.00% in the treatment group, and there were differences between two groups (P<0.05). After treatment, the serum CD3⁺ and CD4⁺ levels in two groups were significantly increased (P<0.05), and the two factors levels in the treatment group were significantly higher than those in the control group (P<0.05). After treatment, the APACHE Ⅱand MEWS scores in two groups were significantly decreased (P<0.05), and which in the treatment group were significantly lower than that in the control group (P<0.05). After treatment, the serum hemoglobin levels in two groups were significantly increased (P<0.05), procalcitonin and copeptin levels were significantly decreased (P<0.05), and these indexes levels in the treatment group were significantly better than those in the control group (P<0.05). Conclusion Lienal Polypeptide Injection combined with imipenem is effective and safe in treatment of severe pulmonary infection in the elderly, can significantly improve the immune function, which has a certain clinical application value.