摘要
目的:比较左氧氟沙星联合头孢哌酮钠-舒巴坦钠或比阿培南应用于医院获得性肺炎(HAP)的临床效果。方法:选取124例HAP患者为研究对象,随机数表法分为观察组与对照组各62例。所有患者均给予左氧氟沙星,对照组联合以头孢哌酮钠-舒巴坦钠方案治疗,观察组则联合以比阿培南进行治疗。比较治疗前及治疗1周后,两组血清炎症因子[降钙素原(PCT)、超敏C反应蛋白(hsCRP)、白细胞介素-6(IL-6)]、诱导痰肺损伤标志物[基质金属蛋白酶-9(MMP-9)、可溶性髓样细胞表达触发受体-1(sTERM-1)、克拉氏细胞分泌蛋白(CC16)]水平变化,分析两组临床症状与体征缓解时间及1周内药物不良反应发生情况。结果:治疗1周后,两组血清PCT、hsCRP、IL-6及诱导痰MMP-9、sTERM-1水平均较治疗前有显著下降,且观察组明显低于同期对照组;两组诱导痰CC16水平均较治疗前有显著提升,且观察组明显高于同期对照组。观察组白细胞计数恢复时间、X线胸片恢复正常时间、病原学检测转阴时间、发热消退时间、啰音缓解时间均明显短于对照组,差异均有统计学意义。治疗1周内,两组各项药物不良反应发生率比较均无统计学意义。结论:两种左氧氟沙星联合药物方案治疗HAP均可获得较为理想的临床效果,其中联合以比阿培南见效更快且并未增加药物不良反应发生风险,对患者预后康复有利。
Objective To compare the clinical effects of levofloxacin combined with cefoperazone sodium and sulbactam sodium or biapenem in hospital acquired pneumonia(HAP).Methods 124 cases of patients with HAP were selected for the study and were divided into observation group and control group according to the random number table method,with 62 cases in each group.All patients were given levofloxacin,and control group was combined with cefoperazone sodium and sulbactam sodium regimen,and observation group was combined with biapenem.The serum inflammatory factors[procalcitonin(PCT),hypersensitive C-reactive protein(hsCRP),interleukin-6(IL-6)]and markers of silicosis injury[matrix metalloproteinase-9(MMP-9),soluble triggering receptors expressed on myeloid cells(sTERM-1),Clara cell secretory 16-kD protein(CC16)]were compared between the two groups before treatment and after 1 week of treatment.The remission times of clinical symptoms and signs and the occurrence of adverse drug reactions within 1 week were analyzed in the two groups.Results After 1 week of treatment,the levels of serum PCT,hsCRP,IL-6 and induced sputum MMP-9 and sTERM-1 were significantly lower than those before treatment,and the levels in observation group were significantly lower than those in control group.The level of induced sputum CC16 in the two groups was significantly higher than that before treatment,and the level in observation group was significantly higher than that in control group.The recovery time of white blood cell count,the recovery time of X-ray chest radiograph,the trans-negative time of etiological detection,the regression time of fever and the relief time of rales in observation group were significantly shorter than those in control group.Within 1 week of treatment,there was no statistically significant difference in the incidence rate of adverse drug reactions between the two groups.Conclusions Two levofloxacin combination regimens can achieve ideal clinical outcomes in the treatment of HAP.The combination of biapenem has fast effects and does not increase the risk of adverse drug reactions,and it is beneficial to the prognosis of patients.
作者
邹娟
周璇
杨凤雪
Zou Juan;Zhou Xuan;Yang Feng-xue(Department of respiratory general,West China Hospital,Sichuan University,Chengdu 610041,China)
出处
《湖南师范大学学报（医学版）》
2020年第3期76-79,共4页
Journal of Hunan Normal University(Medical Sciences)
