摘要
目的研究头孢哌酮钠舒巴坦钠联合喹诺酮类抗菌药物(环丙沙星)对肝炎合并胆道感染患者肝纤维化的影响。方法100例肝炎合并胆道感染患者,根据治疗方法的不同分为对照组和联合组,各50例。对照组给予环丙沙星治疗,联合组在对照组基础上联合头孢哌酮钠舒巴坦钠进行治疗。比较两组患者治疗前后肝功能指标[谷丙转氨酶(ALT)、谷草转氨酶(AST)、γ-谷氨酰转移酶(GGT)、血清总胆红素(TBil)],治疗前后肝纤维化指标[血清透明质酸(HA)、层粘连蛋白(LN)、Ⅲ型前胶原(PCⅢ)],治疗前后炎性指标[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、降钙素原(PCT)],治疗效果,治疗后不良反应发生情况。结果治疗后,两组患者ALT、AST、GGT、TBil均低于本组治疗前,且联合组ALT(66.45±16.46)U/L、AST(102.34±16.52)U/L、GGT(188.66±28.25)U/L、TBil(75.52±12.14)μmol/L均低于对照组的(79.65±17.56)U/L、(122.22±17.31)U/L、(232.66±28.62)U/L、(86.55±13.11)μmol/L,差异具有统计学意义(P<0.05)。治疗后,两组患者HA、LN、PCⅢ均低于本组治疗前,且联合组HA(136.32±60.41)ng/ml、LN(86.96±47.82)ng/ml、PCⅢ(90.46±50.16)μg/L均低于对照组的(174.22±82.65)ng/ml、(116.52±52.11)ng/ml、(121.38±76.52)μg/L,差异具有统计学意义(P<0.05)。治疗后,两组患者IL-6、TNF-α、PCT均低于本组治疗前,且联合组IL-6(56.37±9.21)ng/L、TNF-α(129.34±7.21)ng/L、PCT(4.01±1.27)μg/L均低于对照组的(117.97±12.16)ng/L、(316.79±8.11)ng/L、(6.03±1.66)μg/L,差异具有统计学意义(P<0.05)。联合组患者的治疗总有效率94.00%显著高于对照组的80.00%,差异具有统计学意义(P<0.05)。两组患者治疗后的不良反应发生率比较差异无统计学意义(P>0.05)。结论使用头孢哌酮钠舒巴坦钠联合环丙沙星治疗可以明显改善肝炎合并胆道感染患者的肝纤维化指标,疗效显著,值得推广。
Objective To study the cefoperazone sodium and sulbactam sodium combined with quinolone antibiotics(ciprofloxacin)on hepatic fibrosis in patients with hepatitis and biliary tract infection.Methods A total of 100 patients with hepatitis and biliary tract infection were divided into control group and combination group according to different treatment methods,with 50 cases in each group.The control group was treated with ciprofloxacin,and the combination group was treated with cefoperazone sodium and sulbactam sodium on the basis of the control group.Both groups were compared in terms of liver function indexes[alanine aminotransferase(ALT),aspartate transaminase(AST),gamma-glutamyltransferase(GGT),serum total bilirubin(TBil)],liver fibrosis indexes[serum hyaluronic acid(HA),laminin(LN),typeⅢprocollagen(PCⅢ)]before and after treatment,inflammatory indicators[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),procalcitonin(PCT)]before and after treatment,therapeutic effect,and occurrence of adverse reactions after treatment.Results After treatment,ALT,AST,GGT,and TBil in both groups were lower than those before treatment in this group;the combination group had ALT of(66.45±16.46)U/L,AST of(102.34±16.52)U/L,GGT of(188.66±28.25)U/L,and TBil of(75.52±12.14)μmol/L,which were lower than those of(79.65±17.56)U/L,(122.22±17.31)U/L,(232.66±28.62)U/L,and(86.55±13.11)μmol/L in the control group;the differences were statistically significant(P<0.05).After treatment,HA,LN and PCⅢin both groups were lower than those before treatment in this group;the combination group had HA of(136.32±60.41)ng/ml,LN of(86.96±47.82)ng/ml and PCⅢof(90.46±50.16)μg/L,which were lower than those of(174.22±82.65)ng/ml,(116.52±52.11)ng/ml and(121.38±76.52)μg/L in the control group;the differences were statistically significant(P<0.05).After treatment,IL-6,TNF-αand PCT in both groups were lower than those before treatment in this group;the combination group had IL-6 of(56.37±9.21)ng/L,TNF-αof(129.34±7.21)ng/L and PCT of(4.01±1.27)μg/L,which were lower than those of(117.97±12.16)ng/L,(316.79±8.11)ng/L and(6.03±1.66)μg/L in the control group;the differences were statistically significant(P<0.05).The total effective rate of the combination group was 94.00%,which was significantly higher than that of 80.00%in the control group,and the difference was statistically significant(P<0.05).After treatment,there was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Cefoperazone sodium and sulbactam sodium combined with ciprofloxacin can significantly improve liver fibrosis indexes in patients with hepatitis and biliary tract infection,and the therapeutic effect is significant,which is worthy of promotion.
作者
张秀传
ZHANG Xiu-chuan(Rizhao Institute of Tuberculosis Prevention and Control,Rizhao 276800,China)
出处
《中国现代药物应用》
2023年第13期11-15,共5页
Chinese Journal of Modern Drug Application
关键词
头孢哌酮钠舒巴坦钠
喹诺酮类抗菌药物
肝炎
胆道感染
肝纤维化
Cefoperazone sodium and sulbactam sodium
Quinolone antibiotics
Hepatitis
Biliary tract infection
Hepatic fibrosis
