Effect of ulinastatin plus thymosin-α1 therapy on improving immune function in septic patients

AIM: To investigate the effect of ulinastatin plus thymosin-α1 therapy on improving immune function in septic patients. METHODS: 70 patients were divided into two groups. One group was classical treatment group (CT) with regular therapy and another group was classical treatment plus immunotherapy group (CIT) with ulinastatin plus thymosin-α1 for a week.The immune index before and after treatment on day 0, 1, 3 and 7 was observed, including the clinical and survival data. RESULTS: The most common pathogen of sepsis was bacteria, and infection by fungi was in rare. The common locations of bacteria observed were sputum and abdominal drainage. The level of TNF-α was significant lower in CIT group than that in CT group (P<0.05). IL-10 level was significantly higher in CIT group than that in CT group (P<0.05). IgG level was significant lower in CIT group than that in CT group (P<0.05). No significant difference in the levels of IgA, IgM, C3 and C4 between two groups was observed (P>0.05). CD4+T lymphocytes were significant higher in CIT group than those in CT group (P<0.05). From day 7 to day 28, the lymphocytes and level of HLA-DR in CD14+ monocytes were significant higher in CIT group than those in CT group (P<0.05). The time of mechanical ventilation and vasopressors used in CIT group was shorter than those in CT group (P<0.05). But the length of stay and the cost in ICU showed no significant increase between these two groups (P>0.05). During hospitalization, 20 patients died in the CT group and 13 patients died in CIT group (P<0.05). The long-term survival time in CIT group was longer than that in CT group (P<0.05). CONCLUSION: Immunotherapy in septic patients can decrease TNF-α level and increase IL-10 level. Immunotherapy in septic patients can increase IgG level slightly, CD4+T lymphocyte, and HLA-DR in CD14+ monocytes, which improve the immune paralysis in septic patients. Immunotherapy can shorten the time of mechanical ventilation and vasopressors used, but it doesn’t increase the length of stay and the cost.