Cao Ailing, Feng Fanchao, Zhou Xianmei
Department of Respiratory Medicine, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China.
J Coll Physicians Surg Pak. 2024 Dec;34(12):1497-1507. doi: 10.29271/jcpsp.2024.12.1497.
This systematic review was conducted to assess the curative effect of Thymosin alpha 1 in the acute exacerbation of chronic obstructive pulmonary disease (AECOPD) patients. Six electronic databases including EMBASE, PubMed, Cochrane Library, China National Knowledge Infrastructure Database, Chinese Biomedical Database, and Wanfang Database were searched for eligible papers focusing on the thymosin alpha 1 treatment in AECOPD patients. The effectiveness outcomes included T cell subset, pulmonary function, arterial blood gases, and the length of hospital stay. Stata and Review Manager Software were used for data analysis. Thirty-nine randomised controlled trials with a total of 3,329 patients were included. Compared with the control treatment, Thymosin alpha 1 therapy significantly improved forced expiratory volume in 1 second [MD = 0.29, 95% (0.26, 0.32), p <0.001] and the ratio of forced expiratory volume in the first second to forced vital capacity [MD = 6.24, 95% (3.83, 8.65), p <0.001], increased the arterial partial pressure of oxygen [MD = 7.24, 95% (3.42, 11.07), p = 0.0002], lowered the arterial partial pressure of carbon dioxide [MD = -5.85, 95% (-9.38, -2.33), p = 0.001], shortened the length of hospital stay [MD = -5.39, 95% (-7.82, -2.97), p <0.001], raised the level of CD4+ T lymphocytes count [MD = 7.54, 95%(6.66, 8.41), p <0.001] and the ratio of CD4+/CD8+ [MD = 0.40, 95% (0.34, 0.46), p <0.001], and decreased level of CD8+ T lymphocytes count [MD = -2.74, 95% (-3.86, -1.63), p <0.001]. Thymosin alpha 1 could significantly boost the immune function, and improve pulmonary function and arterial blood gas of AECOPD patients than routine treatment only. More high-quality randomised controlled trials are needed to further confirm Thymosin alpha 1 efficacy. Key Words: Thymosin alpha 1, Efficacy, Acute exacerbation of chronic obstructive pulmonary disease, Meta-analysis.
本系统评价旨在评估胸腺肽α1对慢性阻塞性肺疾病急性加重期（AECOPD）患者的治疗效果。检索了6个电子数据库，包括EMBASE、PubMed、Cochrane图书馆、中国知网数据库、中国生物医学数据库和万方数据库，以查找关于胸腺肽α1治疗AECOPD患者的符合条件的论文。有效性指标包括T细胞亚群、肺功能、动脉血气和住院时间。使用Stata和Review Manager软件进行数据分析。纳入了39项随机对照试验，共3329例患者。与对照治疗相比，胸腺肽α1治疗显著改善了第1秒用力呼气量[MD = 0.29，95%（0.26，0.32），p <0.001]和第1秒用力呼气量与用力肺活量的比值[MD = 6.24，95%（3.83，8.65），p <0.001]，提高了动脉血氧分压[MD = 7.24，95%（3.42，11.07），p = 0.0002]，降低了动脉血二氧化碳分压[MD = -5.85，95%（-9.38，-2.33），p = 0.001]，缩短了住院时间[MD = -5.39，95%（-7.82，-2.97），p <0.001]，提高了CD4+T淋巴细胞计数水平[MD = 7.54，95%（6.66，8.41），p <0.001]和CD4+/CD8+比值[MD = 0.40，95%（0.34，0.46），p <0.001]，降低了CD8+T淋巴细胞计数水平[MD = -2.74，95%（-3.86，-1.63），p <0.001]。胸腺肽α1能显著增强免疫功能，与单纯常规治疗相比，可改善AECOPD患者的肺功能和动脉血气。需要更多高质量的随机对照试验来进一步证实胸腺肽α1的疗效。关键词：胸腺肽α1；疗效；慢性阻塞性肺疾病急性加重期；Meta分析
