目的 探究双歧杆菌四联活菌辅助治疗对慢性阻塞性肺疾病（COPD）稳定期患者BODE指数及免疫炎症因子表达的影响。方法 选取2019年6月—2021年6月在解放军总医院第六医学中心诊治的稳定期COPD患者112例，随机数字表法将研究对象分为对照组和试验组，每组56例。对照组采用常规治疗，试验组在对照组基础上加用双歧杆菌四联活菌辅助治疗。比较两组疗效、治疗前后BODE指数、肺功能［第1秒用力呼气量（FEV₁）、最大呼气流速峰值（PEF）、最大肺活量（FVC）］、免疫功能（CD3⁺、CD4⁺、CD8⁺、CD4⁺/CD8⁺）、炎症因子水平［C反应蛋白（CRP）、白细胞介素-6（IL-6）、可溶性血管细胞黏附分子1（sVCAM-1）］、不良反应发生率。结果 试验组总有效率96.43%，较对照组82.14%显著升高（P＜0.05）；治疗后试验组BODE指数较对照组显著降低（P＜0.05）；治疗后试验组FEV₁、PEF、FVC较对照组显著升高（P＜0.05）；治疗后，试验组患者免疫功能明显优于对照组，差异显著（P＜0.05）；治疗后试验组血清CRP、IL-6、sVCAM-1水平较对照组显著降低（P＜0.05）；两组药物不良反应发生率比较，差异无统计学意义（P＞0.05）。结论 双歧杆菌四联活菌辅助治疗稳定期COPD患者，临床效果好，可以很好缓解患者的症状，改善免疫功能和肺功能，减轻机体炎症，安全性高。

Objective To investigate the effect of probiotics on BODE index and expression of inflammatory cytokines in patients with stable chronic obstructive pulmonary disease (COPD). Methods A total of 112 patients with stable COPD treated in the Sixth Medical Center of the PLA General Hospital were enrolled in the study from June 2019 to June 2021. The subjects were randomly divided into control group and experimental group by random number table method, each group contained 56 samples. The control group was treated with conventional therapy, and the experimental group was treated with probiotics on the basis of the control group. The efficacy, BODE index, pulmonary function (FEV1, PEF, and FVC), immune function (CD3⁺, CD4⁺, CD8⁺, and CD4⁺/CD8⁺), inflammatory factors (CRP, IL-6, and Svcam-1), and adverse reactions were compared between the two groups. Results The total effective rate of experimental group was 96.43%, which was higher than that of control group (82.14%, P < 0.05), the BODE Index of experimental group was lower than that of control group after treatment (P < 0.05) , the FEV1, PEF, FVC of experimental group were higher than that of control group after treatment (P < 0.05). After treatment, the levels of CRP, IL-6 and Svcam-1 in the experimental group were significantly lower than those in the control group (P < 0.05), there was no significant difference in the incidence of adverse drug reactions between the two groups (P > 0.05). Conclusion Probiotics as an adjunctive therapy for COPD patients in stable stage has a good clinical effect, which can relieve the symptoms, improve the immune function and lung function, and reduce the inflammation of the body, high security.

R974

海军总医院创新培育基金（CXPY201725）