Abstract：Objective: To explore the effectiveness of piperacillin tazobactam and imipenem cilastatin sodium in the treatment of severe pneumonia and their impact on inflammatory factor levels and prognosis. Methods: A total of 105 patients with severe pneumonia admitted to our hospital from January 2020 to March 2023 were selected. Using a random number table, they were divided into Group A (n=53) treated with imipenem cilastatin sodium and Group B (n=52) treated with piperacillin tazobactam sodium. Clinical symptom disappearance times (cough, pulmonary shadow, pulmonary rales, temperature recovery time) were compared between the two groups. The severity [Clinical Pulmonary Infection Score (CPIS), Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ), Murray Lung Injury Score (MLIS)], blood gas parameters [oxygen saturation (SpO2), partial pressure of oxygen (PaO2), partial pressure of carbon dioxide (PaCO2)], and levels of inflammatory factors [white blood cell count (WBC), C-reactive protein (CRP), procalcitonin (PCT)] were compared before and after 7 days of treatment. Adverse reactions were recorded. Results: Group B had shorter times for cough, disappearance of pulmonary shadow, pulmonary rales, and temperature recovery than Group A (P<0.05). After 7 days of treatment, both groups showed significant reductions in CPIS, APACHE Ⅱ, MLIS scores, PaCO2, and inflammatory factors (WBC, CRP, PCT), with larger reductions in Group B (P<0.05). Some blood gas parameters (SpO2, PaO2) significantly increased, with greater changes in Group B (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion: Piperacillin tazobactam sodium and imipenem cilastatin sodium can alleviate the condition and clinical symptoms of patients with severe pneumonia, improve blood gas conditions, and relieve inflammatory reactions. However, piperacillin tazobactam sodium shows better efficacy.
王亮亮, 王凯, 曹继飞, 尉玉杰. 两种抗感染药物治疗重症肺炎的效果及炎症因子水平预后比较[J]. 河北医学, 2024, 30(1): 153-157.
WANG Liangliang, et al. Comparison of the Effects of Two Anti-Infective Drugs on Severe Pneumonia, Inflammatory Factor Levels, and Prognosis. HeBei Med, 2024, 30(1): 153-157.
[1] 甘惠玲,赵双平.APACHEⅡ评分对重症肺炎致急性肺损伤患者撤机结局的预测价值[J].内科急危重症杂志,2019,25(2):123-125. [2] 宋林燕,杨晓帆,黄正米,等.亚胺培南西司他丁联合利奈唑胺治疗老年重症肺炎的研究[J].西北药学杂志,2023,38(3):172-175. [3] 李静,杨静容,李亚兰,等.小儿肺炎支原体肺炎血清CRPPCT及ESR水平与MPP病情严重程度的关系[J].西部医学,2021,33(9):1374-1378. [4] Knaus W A,Zimmerman J E,Wagner D P,et al.APACHEacute physiology and chronic health evaluation:a physiologically based classification system[J].Crit Care Med,1981,9(8):591-597. [5] 吴瑶,彭洁,谢梅,等.经纤维支气管镜行支气管肺泡灌洗术治疗重症肺炎疗效及动脉血气指标和呼吸动力学的影响[J].河北医学,2021,27(7):1123-1127. [6] Maor Y,Cohen D,Paran N,et al.Compassionate use of convalescent plasma for treatment of moderate and severe pneumonia in COVID-19 patients and association with IgG antibody levels in donated plasma[J].EClinical Medicine,2020,12(7):794-796. [7] 李敏,邵换璋.热毒宁注射液联合哌拉西林钠他唑巴坦钠治疗重症肺炎的临床研究[J].现代药物与临床,2022,37(12):2790-2794. [8] 张荣嘎,夏正海,戴礼兰,等.亚胺培南西司他丁钠联合环丙沙星治疗重症肺炎的临床效果及对血清C反应蛋白水平的影响[J].中国医院药学杂志,2020,40(24):2574-2577. [9] 王国玉,巴春贺,李彤,等.老年慢性心力衰竭患者肺部感染的危险因素及其对PCT、NT-proBNP及氧化应激指标的影响[J].中南医学科学杂志,2023,51(1):110-113. [10] 冯献荣,吴楠,牛微微.乌司他丁联合注射用亚胺培南西司他丁钠治疗重症肺炎伴呼吸衰竭的临床效果[J].中国医药导报,2020,17(3):123-126.
2024, Vol. 30 
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