目的 探究雙歧桿菌四聯(lián)活菌輔助治療對慢性阻塞性肺疾病（COPD）穩(wěn)定期患者BODE指數(shù)及免疫炎癥因子表達的影響。方法 選取2019年6月—2021年6月在解放軍總醫(yī)院第六醫(yī)學中心診治的穩(wěn)定期COPD患者112例，隨機數(shù)字表法將研究對象分為對照組和試驗組，每組56例。對照組采用常規(guī)治療，試驗組在對照組基礎上加用雙歧桿菌四聯(lián)活菌輔助治療。比較兩組療效、治療前后BODE指數(shù)、肺功能［第1秒用力呼氣量（FEV₁）、最大呼氣流速峰值（PEF）、最大肺活量（FVC）］、免疫功能（CD3⁺、CD4⁺、CD8⁺、CD4⁺/CD8⁺）、炎癥因子水平［C反應蛋白（CRP）、白細胞介素-6（IL-6）、可溶性血管細胞黏附分子1（sVCAM-1）］、不良反應發(fā)生率。結(jié)果 試驗組總有效率96.43%，較對照組82.14%顯著升高（P＜0.05）；治療后試驗組BODE指數(shù)較對照組顯著降低（P＜0.05）；治療后試驗組FEV₁、PEF、FVC較對照組顯著升高（P＜0.05）；治療后，試驗組患者免疫功能明顯優(yōu)于對照組，差異顯著（P＜0.05）；治療后試驗組血清CRP、IL-6、sVCAM-1水平較對照組顯著降低（P＜0.05）；兩組藥物不良反應發(fā)生率比較，差異無統(tǒng)計學意義（P＞0.05）。結(jié)論 雙歧桿菌四聯(lián)活菌輔助治療穩(wěn)定期COPD患者，臨床效果好，可以很好緩解患者的癥狀，改善免疫功能和肺功能，減輕機體炎癥，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

海軍總醫(yī)院創(chuàng)新培育基金（CXPY201725）