摘要
目的探讨哌拉西林/他唑巴坦治疗社区获得性肺炎（CAP）临床疗效。方法收集2016年3月至2017年3月松阳县人民医院的CAP患者100例，采用随机数字表法分为两组各50例，哌拉西林/他唑巴坦组予以哌拉西林/他唑巴坦治疗，头孢噻肟钠组予以头孢噻肟钠治疗，比较两组相关临床指标、临床疗效、影像学治疗效果、血液指标、血气分析与炎性指标。结果哌拉西林/他唑巴坦组临床症状消失时间、住院时间与住院费用分别为（3.77±1.12）d、（8.44±2.47）d、（1 780±489）元，均低于头孢噻肟钠组的（5.36±1.70）d、（11.37±3.68）d、（2 136±470）元（t＝5.523、4.675、3.711，均P〈0.01）；治疗显效率为90%，明显高于头孢噻肟钠组的70%（χ2＝6.25，P〈0.05）；影像学治疗显效率为94%，高于头孢噻肟钠组的68%（χ2＝10.981，P〈0.01）；治疗后白细胞计数及中性粒细胞百分比分别为（7.30±1.08）×10^9/L、（0.65±0.04），均低于头孢噻肟钠组的（8.66±1.25）×10^9/L、（0.71±0.04）（t＝5.821、7.405，均P〈0.01）；血氧饱和度为（81.90±6.83）%，高于头孢噻肟钠组的（74.20±6.27）%（χ2＝5.873，P〈0.01）；C反应蛋白、降钙素原、白细胞介素1β与肿瘤坏死因子α水平分别为：（6.77±4.06）mg/L、（0.72±0.35）μg/mL、（11.58±3.64）pg/mL、（93.27±10.20）pg/mL，均低于头孢噻肟钠组的（14.87±6.29）mg/L、（0.10±0.06）μg/mL、（17.27±4.07）pg/mL、（120.76±21.54）pg/mL（t＝7.651、12.346、7.369、8.156，均P〈0.01）。结论哌拉西林/他唑巴坦治疗CAP临床疗效显著，可以推广应用。
ObjectiveTo investigate the clinical efficacy of piperacillin/tazobactam in the treatment of community acquired pneumonia （CAP）.Methods100 cases of CAP in Songyang People＇s Hospital from March 2016 to March 2017 were collected and randomly divided into two groups according to the digital table, with 50 cases in each group.The piperacillin/tazobactam group was treated with piperacillin/tazobactam, and the cefotaxime sodium group was given cefotaxime sodium.The clinical indicators, symptoms and imaging effects, blood indicators, blood gas analysis and inflammatory indicators were compared between the two groups.ResultsThe clinical symptoms disappeared time, hospitalization time and hospitalization expenses in the piperacillin/tazobactam group were （3.77±1.12）d, （8.44±2.47）d, （1 780±489）CNY, respectively, which were significantly lower than those in the cefotaxime sodium group [（5.36±1.70）d, （11.37±3.68）d, （2 136±470）CNY, t=5.523, 4.675, 3.711, all P〈0.01]. The effective rate of the piperacillin/tazobactam group was 90%, which was significantly higher than 70% of the cefotaxime sodium group （χ2=6.25, P〈0.05）. The effective rate of imaging treatment in the piperacillin/tazobactam group was 94%, which was significantly higher than 68% in the cefotaxime sodium group （χ2=10.981, P〈0.01）. After treatment, the WBC and neutrophil percentage of the piperacillin/tazobactam group were （7.30±1.08）×10^9/L, （0.65±0.04）, respectively, which were significantly lower than those of the cefotaxime sodium group [（8.66±1.25）×10^9/L, （0.71±0.04）, t=5.821, 7.405, all P〈0.01]. The PaO2 level of the piperacillin/tazobactam group was significantly higher than that of the cefotaxime sodium group [（81.90±6.83）% vs.（74.20±6.27）%, t=5.873, P〈0.01]. The levels of CRP, PCT, IL-1 and TNF-α in the piperacillin/tazobactam group were （6.77±4.06）mg/L, （0.72±0.35）μg/mL, （11.58±3.64）pg/mL, （93.27±10.20）pg/mL, which were significantly lower than those in the cefotaxime sodium group [（14.87±6.29）mg/L, （0.10±0.06）μg/mL, （17.27±4.07）pg/mL, （120.76±21.54）pg/mL, t=7.651, 12.346, 7.369, 8.156, all P〈0.01].ConclusionThe clinical efficacy of piperacillipine/tazobactam in the treatment of CAP is significant, and it has reference significance.
作者
潘小娟
Pan Xiaojuan(Department of Internal Medicine ,the People＇s Hospital of Songyang County ,Zhejiang 323400, Chin)
出处
《中国基层医药》
CAS
2018年第12期1501-1505,共5页
Chinese Journal of Primary Medicine and Pharmacy
基金
国家卫生计生委医药卫生科技发展课题（2X-01-c2016126）
