谷氨酰胺联合比阿培南对老年重症肺炎患者的疗效及血清肺表面活性蛋白的影响  

Effect of glutamine combined with biapenem on serum surfactant protein in elderly patients with severe pneumonia

作　　者：赵立群[1] 李雅莉[2] 徐灵彬[3] 张娟妮[4] 张洁[2] ZHAO Liqun;LI Yali;XU Lingbin;ZHANG Juanni;ZHANG Jie(Respiratory Medicine Department,The Fourth Hospital ofXi'an,Xi'an 710004,China;Respiratory Medicine Department,The Second Affiliated Hospital of Xi'an Jiao Tong University,Xi'an 710004,China;Respiratory Medicine Department,Shaanxi People's Hospital,Xi'an 710068,China;Public Health,Xian Medical College,Xi'an 710068,China)

机构地区：[1]西安市第四医院呼吸内科,陕西西安710004 [2]西安交通大学第二附属医院呼吸内科,陕西西安710004 [3]陕西省人民医院呼吸内科,陕西西安710068 [4]西安医学院公共卫生系,陕西西安710068

出　　处：《药物评价研究》2018年第10期1859-1862,共4页Drug Evaluation Research

摘　　要：目的研究谷氨酰胺联合比阿培南对老年重症肺炎患者血清肺表面活性蛋白的影响。方法选择2012年1月—2017年12月在西安市第四医院进行诊治的232例老年重症肺炎患者,随机分为两组。对照组静脉注射比阿培南,观察组联合静脉滴注谷氨酰胺。两组均治疗7 d。比较两组的住院时间、临床症状改善时间、血清肺表面活性蛋白水平和肺功能。结果观察组的有效率明显高于对照组,差异有统计学意义(P<0.05)。观察组的咳嗽消失时间、体温恢复正常时间、平均住院时间以及肺部X线吸收改善时间均明显短于对照组,差异有统计学意义(P<0.05)。两组治疗后的血清肺表面活性蛋白A(SP-A)以及肺表面活性蛋白D(SP-D)水平均明显升高,同组治疗前后比较差异有统计学意义(P<0.05);且观察组明显高于对照组,差异有统计学意义(P<0.05)。两组治疗后的FEV1、FVC、MEF25、PEF以及MWV50均明显升高,同组治疗前后比较差异有统计学意义(P<0.05);且观察组明显高于对照组,差异有统计学意义(P<0.05)。结论谷氨酰胺联合比阿培南对老年重症肺炎患者具有较好的治疗效果,其机制可能与升高血清肺表面活性蛋白水平,增强气道局部防御以及免疫调节功能相关。Objective To study the effect of glutamine combined with biapenem on serum surfactant protein in elderly patients with severe pneumonia.Methods Selected 232 cases of patients with severe pneumonia who were treated in our hospital from January 2013 to December 2017, divided into two groups randomly. The control group was intravenously injected with biapenem, and the observation group was given glutamine.Results After treatment, the effective rate of the observation group was significantly higher control group (P<0.05). The cough disappearance time, the recovery time of body temperature, the average hospitalization time and the improvement time of pulmonary X-ray absorption in the observation group were significantly shorter than those in the control group (P<0.05). The serum SP-D and SP-A levels of the two groups increased significantly after treatment (P<0.05), and the observation group was more obvious (P<0.05). After treatment, FEV1, FVC, MEF25, PEF and MWV50 in the two groups were significantly increased (P<0.05), and the observation group was more significant (P<0.05). Conclusion The combination of glutamine and biapenem has a better therapeutic effect on the elderly patients with severe pneumonia. The mechanism may be related to increasing the level of serum lung surface active protein, enhancing the local defense of the airway and the function of immunoregulation.

关 键 词：谷氨酰胺 比阿培南 老年重症肺炎 肺表面活性蛋白 

分 类 号：R969[医药卫生—药理学]