比阿培南联合莫西沙星对老年重症肺炎患者炎性指标及不良反应的影响

doi:10.3969/j.issn.1006-6233.2020.05.005

摘要
图/表
参考文献
相关文章 (15)

全文: PDF (1222 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要 目的:探讨比阿培南联合莫西沙星治疗老年重症肺炎(SP)的临床效果。方法:回顾性选取2016年6月至2019年7月我院老年SP患者81例,按治疗方案不同分为3组,各27例。3组均实施常规治疗,对照1组予以比阿培南治疗,对照2组予以莫西沙星治疗,观察组予以比阿培南联合莫西沙星治疗。比较3组疗效、临床症状及体征改善时间、治疗前后病原菌检出率、炎性因子[血清降钙素原(PCT)、白细胞计数(WBC)、超敏C反应蛋白(hs-CRP)]、T淋巴细胞亚群(CD3、CD4、CD8)水平,统计3组不良反应发生情况。结果:观察组总有效率92.59%(25/27)高于对照1组、对照2组,治疗后革兰阴性菌检出率7.41%(2/27)低于对照1组、对照2组(P<0.05);观察组机械通气时间、退热时间、痰液性状改变时间、白细胞下降时间、肺部炎症明显吸收时间短于对照1组、对照2组(P<0.05);治疗后观察组血清PCT、WBC、hs-CRP水平低于对照1组、对照2组,CD3、CD4、CD8水平高于对照1组、对照2组(P<0.05);3组不良反应发生率对比,差异无统计学意义(P>0.05)。结论:比阿培南联合莫西沙星治疗老年SP疗效显著,能有效抑制炎症反应,改善免疫功能,且不良反应少,安全性高。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章

关键词 ：比阿培南, 莫西沙星, 重症肺炎, T淋巴细胞亚群, 炎性因子

Abstract：Objective:To investigate the clinical effect of biapenem combined with moxifloxacin in the treatment of elderly severe pneumonia (SP). Methods: Eighty-one elderly patients with SP in our hospital from June 2016 to July 2019 were selected and divided into three groups according to different treatment, 27 cases in each. All three groups were treated with routine treatment. The control group one was treated with biapenem, the control group two was treated with moxifloxacin, and the observation group was treated with biapenem combined with moxifloxacin. Comparison was made in fficacy, clinical symptoms and signs improvement time, detection rate of pathogenic bacteria before and after treatment, inflammatory factors [serum calcitonin (PCT), white blood cell count (WBC), high-sensitivity C-reactive protein (hs-CRP)], T-lymph Cell subsets (CD3, CD4, CD8) levels in three groups.The incidence of adverse reactions in the three groups was counted. Results: The total effective rate of observation group was 92.59% (25/27) higher than that of control group one and control group two. The detection rate of gram-negative bacteria after treatment was 7.41% (2/27) lower than that of control group one and control group two (P<0.05); mechanical ventilation time, antipyretic time, sputum trait change time, leukocyte decline time, and significant pulmonary inflammation absorption time in the observation group were shorter than those in control group one and control group two (P<0.05); After treatment, the levels of PCT, WBC and hs CRP in the observation group were lower than those in the control group one and two, and the levels of CD3, CD4 and CD8 were higher than those in the control group one and two (P<0.05).Conclusion: Biapenem combined with moxifloxacin has significant curative effect on elderly SP. It can inhibit the inflammatory response and improve immune function, with less adverse reactions and high safety.

Key words： Biapenem Moxifloxacin Severe pneumonia T lymphocyte subsets Inflammatory factors

基金资助:安徽省卫生厅科研课题,(编号:2018168209)

通讯作者: 刘丽

引用本文:

龚敬, 陆伟, 史刚, 张肖难, 刘丽. 比阿培南联合莫西沙星对老年重症肺炎患者炎性指标及不良反应的影响[J]. 河北医学, 2020, 26(5): 721-727.
GONG Jing, LU Wei, SHI Gang, et al. Effects of Biapenem and Moxifloxacin on Inflammatory Parameters and Adverse Reactions in Elderly Patients with Severe Pneumonia. HeBei Med, 2020, 26(5): 721-727.

链接本文:

http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2020.05.005 或 http://www.hbyxzzs.cn/CN/Y2020/V26/I5/721

[1] Phua J,Dean NC,Guo Q,et al.Severe community-acquired pneumonia: Timely management measures in the first 24 hours[J].Crit Care,2016,20(1):237.
[2] 龙思琪,马莉,陈敏,等.婴幼儿重症和非重症肺炎淋巴细胞亚群的差异分析[J].中国免疫学杂志,2016,32(3):401~404.
[3] 中国医师协会急诊医师分会.中国急诊重症肺炎临床实践专家共识[J].中国急救医学,2016,36(2):97~107.
[4] 巫太平,刘玲.血清S-ChE LPO及血常规联合检测对老年重症肺炎预后的评估[J].河北医学,2019,25(9):1459~1462.
[5] 孙兵,唐晓,李绪言,等.2017-2018年冬春季重症流感病毒性肺炎所致急性呼吸窘迫综合征的临床特点及预后危险因素分析[J].中华结核和呼吸杂志,2019,42(1):9~14.
[6] 薛世民,蒋伟,贾娟,等.莫西沙星治疗老年支原体肺炎患者的临床疗效分析[J].现代生物医学进展,2016,16(18):3551~3554.
[7] 何清,刘韬滔,冯喆.亚胺培南与莫西沙星治疗重症肺炎的临床疗效对比研究[J].国际呼吸杂志,2018,38(6):414~418.
[8] 马丽苹,徐若华,詹秀玲,等.比阿培南联合左氧氟沙星治疗老年重症肺炎的临床效果观察[J].临床误诊误治,2017,30(12):83~86.
[9] Mizgerd JP.Pathogenesis of severe pneumonia: advances and knowledge gaps[J].Curr Opin Pulm Med,2017,23(3):193~197.
[10] 付小龙,段伟,苏崇余,等.IL-6协同M-CSF体外诱导CD14~+单核细胞向M2样巨噬细胞分化[J].免疫学杂志,2016,32(12):1013~1018.
[11] Feucht J,Kayser S,Gorodezki D,et al.T-cell responses against CD19+ pediatric acute lymphoblastic leukemia mediated by bispecific T-cell engager (BiTE) are regulated contrarily by PD-L1 and CD80/CD86 on leukemic blasts[J].Oncotarget,2016,7(47):76902~76919.
[12] 李瑞萍,宋伟.血浆sTREM-1、sFLT-1及APACHEⅡ评分对重症肺炎患者预后评估价值[J].国际呼吸杂志,2018,38(13):968~971.