Braga M, Costantini E, Di Francesco A, Gianotti L, Baccari P, Di Carlo V
Department of Surgery, Scientific Institute Hospital San Raffaele, Milan, Italy.
Br J Surg. 1994 Feb;81(2):205-8. doi: 10.1002/bjs.1800810216.
The effectiveness of perioperative administration of thymopentin in preventing postoperative infection was evaluated in 206 patients with cancer (54 gastric, 152 colorectal) who underwent elective major surgery. Comparable subsets of patients were obtained with respect to age (proportion over 65 years) and nutritional status (patients with serum albumin level less than 30 milligrams or weight loss of 10 per cent or more of usual body-weight were considered to be malnourished). Patients were then randomly assigned to a control group or to a group receiving thymopentin. All patients received perioperative short-term antibiotic prophylaxis and postoperative parenteral nutrition. Levels of CD3-, CD4- and CD8-positive T cell subsets were evaluated before and after surgery in 20 (ten elderly) patients from each group. The severity of postoperative infection was evaluated using a sepsis score. In elderly patients thymopentin prevented the postoperative drop in CD3- and CD4-positive T cell subpopulations that was observed in controls (P < 0.05d). The postoperative infection rate was 17.5 per cent in the group given thymopentin and 24.3 per cent in controls (P not significant). The mean (s.d.) sepsis score was 6.7 (3.1) in the group receiving thymopentin and 9.4 (5.8) in controls (P not significant). Considering only elderly patients, the mean (s.d.) sepsis score was significantly lower in those treated with thymopentin than in control patients (6.9(2.1) versus 11.3(4.7)). In conclusion, administration of thymopentin did not significantly reduce the postoperative infection rate. However, it prevented the drop in number of CD3- and CD4-positive T cells after operation and reduced the severity of postoperative infection in elderly patients.
对206例接受择期大手术的癌症患者（54例胃癌、152例结直肠癌）进行了评估，以研究围手术期给予胸腺五肽预防术后感染的有效性。根据年龄（65岁以上的比例）和营养状况（血清白蛋白水平低于30毫克或体重减轻超过正常体重的10%或更多的患者被视为营养不良）获得了可比的患者亚组。然后将患者随机分为对照组或接受胸腺五肽的组。所有患者均接受围手术期短期抗生素预防和术后肠外营养。每组20例（10例老年患者）患者在手术前后评估CD3、CD4和CD8阳性T细胞亚群水平。使用脓毒症评分评估术后感染的严重程度。在老年患者中，胸腺五肽可预防对照组中观察到的术后CD3和CD4阳性T细胞亚群的下降（P<0.05）。接受胸腺五肽治疗的组术后感染率为17.5%，对照组为24.3%（P无统计学意义）。接受胸腺五肽治疗的组平均（标准差）脓毒症评分为6.7（3.1），对照组为9.4（5.8）（P无统计学意义）。仅考虑老年患者，接受胸腺五肽治疗的患者平均（标准差）脓毒症评分显著低于对照组患者（6.9（2.1）对11.3（4.7））。总之，给予胸腺五肽并未显著降低术后感染率。然而，它可预防术后CD3和CD4阳性T细胞数量的下降，并降低老年患者术后感染的严重程度。
