目的 比较不同免疫调节治疗方案对老年脓毒症合并免疫抑制患者免疫功能及预后的影响。方法 91 例老年脓毒症合并免疫抑制患者，随机分为对照组（A 组，30 例）、胸腺法新治疗组（B 组， 30 例）和胸腺法新联合血必净注射液治疗组（C 组，31 例），比较三组 CD3+T 细胞计数、CD4+T 细胞计数、 CD4+ /CD8+T 细胞比值及人白细胞 DR 抗原（HLA⁃DR）表达率等免疫功能和 ICU 住院时间、总住院时间、90 d 病死率的差异。结果 与 A 组比较，B 组及 C 组治疗后 CD3+T 细胞计数、CD4+T 细胞计数、CD4+ /CD8+T 细胞比值、HLA⁃DR 表达率均显著上升，总住院时间及 90 d 病死率显著下降，差异有统计学意义（P＜0.05）。与 B组比较，C组治疗后CD3+T细胞计数、CD4+T细胞计数及HLA⁃DR表达率较治疗前均显著上升，ICU住院时 间及总住院时间显著下降，差异有统计学意义（P＜0.05）。结论 老年脓毒症免疫抑制患者应用胸腺法新或联合血必净注射液可以改善的免疫功能及预后，联合治疗具有协同作用，优于单独使用胸腺法新。

Objective To compare the effects of different immunotherapy on mmunologic function and prognosis in elderly immunosuppressive patients with sepsis. Methods Ninety⁃one elderly patients with immuno⁃ suppressive of sepsis were randomly divided into control group（A group，n = 30）and thymalfasin treatment group （B group，n = 30）and thymalfasin combined with Xuebijing treatment group（C group，n = 31）. The changed of the mmunologic function such as CD3+ T cell count and CD4+ T cell count and the ratio of CD4+ /CD8+ T cell count and human leukocyte antigen DR expression rate，ICU length of hospital stay，total length of stay in hospital and 90⁃ day mortality were compared and analyzed. Results The CD3 + T cell count，CD4 + T cell count，the ratio of CD4+ /CD8+ T cell count and the expression rates of HLA⁃DR increased significantly after treatment and total length of stay in hospital and 90⁃day mortality rate were decreased significantly in group B and group C when compared with those in group A（P < 0.05）. The CD3+ T cell count，CD4+ T cell count，and the expression rates of HLA⁃DR increased significantly and the length of stay in ICU and total length of stay in hospital decreased significantly in group C when compared with those in group B after treatment（P < 0.05）. Conclusion In elderly immunosuppressive patients with sepsis，the use of thymalfasin or combined with Xuebijing injection can improve the mmunologic func⁃ tion and prognosis. Combination therapy has synergistic effect and is superior to single thymalfasin treatment.