RESUMO
To investigate the effectiveness of thymosin a1 on patients with severe community-acquired pneumonia (SCAP). Methods Thirty-five patients with SCAP were randomly divided into two groups, group A with regular treatment as control and group B with both thymosin a1 and regular treatment. Venous blood specimens were collected from them before treatment (baseline) and seven days after treatment for laboratory testing, including serum concentrations of c-reactive protein (CRP) and albumen (ALB), serum activities of aspartate aminotransferase (AST) and aniline aminotransferase ( ALT), and percentage of T-lymphocyte subsets CD3+ , CD+ and CD8+ by indirect immunofluorescence. Meanwhile, their symptoms, signs and chest X-ray were observed. Length of mechanical ventilation and stay at emergency intensive care units (EICU) of the patients were recorded. Results Percentages of CD3+ and CD4+ , and ratio of CD+ to CD8 + increased significantly and percentage of CD8+ reduced significantly in group B seven days after treatment, as compared to those before treatment [ (46.3 ± 5.3) % vs. (29.9 ± 2.1 ) %, (44.5 ± 5.2) % vs. (28. 7 ± 2. 8 ) %, and 1.8 ± 0. 4 vs. 0. 9 ± 0. 1, respectively, P < 0.05, and (24.6 ± 2.9) % vs. (31.4 ± 3.7) %, P < 0. 05 ]. But, no significant improvements in those indicators were found in group A after treatment. There were significant differences in percentages of CD3+ , CID4+ and CD8 + , and ratio of CD4+ to CD8+ between group B and group A after trestmenL Serum concentration of ClIP reduced in both groups after treatment, as compared to that before treatment, but reduced more significantly in group B than that in group A. Serum concentration of ALB increased slightly in both groups after treatment, more in group B than that in group A, as compared to that before treatment. However, no significant difference in occurrence of ventilator-associated pneumonia ( VAP ) was found between the two groups (44.4% vs. 17.7%, P > 0.05 ) . Length of mechanical ventilation and stay at EICU were significantly shorter in group B than those in group A [ ( 8.4 ± 2.7 ) d vs. ( 5.1 ± 1.6 ) d, P < 0.05 ; and ( 16.1±2.9) d vs. ( 11.7 ± 2. 3 ) d, P < 0.01 ], and overall cure rates improved significantly in group B than that in group A (76.5% vs. 44.4%, P < 0.05 ), but no difference in case-fatality ratio was found between the two groups (33.3% vs. 23.5%, P >0.05).Conclusions Immune status of patients with SCAP could be improved by thymosin a1, with a shorter length of mechanical ventilation and stay at EICU, to promote their recovery.