摘要
目的评价哌拉西林钠他唑巴坦钠联合左氧氟沙星对铜绿假单胞菌肺炎的疗效。方法选取94例在防城港市中医医院接受住院治疗的铜绿假单胞菌肺炎患者作为研究对象,随机分为对照组和观察组,每组47例。对照组采用左氧氟沙星治疗,观察组在对照组治疗的基础上采用哌拉西林钠他唑巴坦钠治疗。比较2组的临床症状改善情况、临床综合疗效、细菌学疗效、免疫功能、肺功能、血清炎症因子水平。结果观察组治疗后的退热时间、止咳时间和咳痰消失时间均明显短于对照组(P<0.05);治疗后,2组的总有效率和细菌清除率均明显提高,2组比较差异有统计学意义(P<0.05);治疗后,2组的血清C反应蛋白(C-reactive protein,CRP)和血清淀粉样蛋白A(serum amyloid A,SAA)水平均明显下降,且观察组的下降幅度明显优于对照组(P<0.05);治疗4周后,观察组的CD4^(+)水平较治疗前有所上升,CD8^(+)水平较治疗前有所下降(P<0.05),观察组的CD4^(+)/CD8^(+)值高于对照组,CD8^(+)水平则低于对照组(P<0.05);治疗4周后,2组的第1秒用力呼气容积(forced expiratory volume for 1 second,FEV1)、用力肺活量(forced vital capacity,FVC)和动态肺顺应性(dynamic lung compliance,Cdyn)水平较治疗前升高,且观察组的各指标均高于对照组(P<0.05);观察组治疗期间不良反应总发生率低于对照组(P<0.05)。结论哌拉西林钠他唑巴坦钠联合左氧氟沙星可有效治疗铜绿假单胞菌肺炎,减轻患者的发热、咳嗽、咳痰等症状,减少体内的铜绿假单胞菌数量,提高患者的免疫功能,改善肺功能,降低血清CRP、SAA等炎症因子水平,且不良反应较少。
Objective To evaluate the efficacy of piperacillin sodium and tazobactam sodium combined with levofloxacin in the treatment of pseudomonas aeruginosa pneumonia.Methods 94 patients with pseudomonas aeruginosa pneumonia who were hospitalized in Fangchenggang Hospital of Traditional Chinese Medicine were selected as the study objects.The patients were randomly divided into a control group and an observation group,47 cases in each group.The control group was treated with levofloxacin,and the observation group was treated with piperacillin sodium and tazobactam sodium on the basis of the control group.The improvement of clinical symptoms,clinical comprehensive efficacy,bacteriological efficacy,immune function,lung function and serum inflammatory factors were compared between the 2 groups.Results The time of fever,cough and expectoration in the observation group were significantly shorter than those in the control group(P<0.05).After treatment,the total effective rate and bacterial clearance rate of the 2 groups were significantly increased,and the difference between the 2 groups was statistically significant(P<0.05).After treatment,the levels of serum C-reactive protein(CRP)and serum amyloid A(SAA)in the 2 groups were significantly decreased,and the decrease of the observation group was significantly higher than that of the control group(P<0.05).After 4 weeks of treatment,the level of CD4^(+)in the observation group was increased,and the level of CD8^(+)was decreased(P<0.05).The ratio of CD4^(+)/CD8^(+)in the observation group was higher than that in the control group,while the level of CD8^(+)was lower than that in the control group(P<0.05).After 4 weeks of treatment,the forced expiratory volume for 1 second,the levels of FEV1,forced vital capacity(FVC)and dynamic lung compliance(Cdyn)were higher than those before treatment,and the indices in the observation group were higher than those in the control group(P<0.05).The total incidence of adverse reactions in the observation group was lower than that in the control group(P<0.05).Conclusion The combination of piperacillin sodium and tazobactam sodium with levofloxacin can effectively treat pseudomonas aeruginosa pneumonia,reduce fever,cough,sputum and other symptoms of patients,reduce the number of pseudomonas aeruginosa in the body,improve the immune function of patients,enhance lung function,reduce the levels of serum CRP,SAA and other inflammatory factors,and have fewer adverse reactions.
作者
张荣昶
林韩东
韦俊全
庞业展
ZHANG Rongchang;LIN Handong;WEI Junquan;PANG Yezhan(Department of Respiratory,Traditional Chinese Medicine Hospital of Fangchenggang City,Fangchenggang 538021,China)
出处
《西北药学杂志》
CAS
2024年第6期80-86,共7页
Northwest Pharmaceutical Journal
基金
广西壮族自治区卫生健康委员会自筹经费科研课题(编号:z-p20221935)。
