抗生素联合强的松治疗急性脓肿型非哺乳期乳腺炎的疗效观察及对外周血CD^4+/CD^8+比值的影响  

Efficacy of Antibiotic Combi Prednisone in Acute Abscess Type Non-lactating Mastitis and the Effect on Peripheral Blood CD^(4+)/CD^(8+) Ratio

作　　者：董明春 叶光荣[2] 张伟[2] 廖铭兴[3] 

机构地区：[1]四川省米易县妇幼保健院,四川米易617200 [2]四川省攀枝花市第四人民医院皮肤性病科,四川攀枝花617061 [3]福建省龙岩市第一医院甲乳科,福建龙岩364000

出　　处：《河北医学》2016年第1期95-99,共5页Hebei Medicine

基　　金：福建省卫生厅青年科研课题资助计划,(编号:2011-1-44)

摘　　要：目的:探讨采用抗生素联合强的松治疗急性脓肿型非哺乳期乳腺炎的临床疗效,及其对外周血CD^(4+)/CD^(8+)比值的影响,以及安全性评价。方法:选择乳腺外科2012年6月至2014年12月收治的120例急性脓肿型非哺乳期乳腺炎的患者作为观察对象,随机分为两组,每组60例;对照组予行脓肿引流配合口服阿莫西林片治疗,0.5g/次,tid;观察组在对照组的基础上加用强的松20mg,bid(早晚餐后),14d为1疗程,均于1个疗程后评价两组治疗效果差异及不良反应发生情况。结果:观察组的有效率86.4%(51/59),明显高于对照组的有效率75.9%(44/58),差异具有统计学意义(P<0.05)。并且观察组在痊愈率、痊愈时间方面均优于对照组(均P<0.05)。治疗后两组的外周血淋巴细胞CD^(4+)百分率CD^(4+)/CD^(8+)比值均有不同程度下降(均P<0.05),而观察组下降更为明显(P<0.05);观察组CD^(8+)百分率明显升高(P<0.05),对照组升高不明显(P>0.05),差异无统计学意义;CD^(4+)/CD^(8+)比值比较,观察组显著低于对照组,(P<0.05),差异具有统计学意义。两组均未见到明显的不良反应发生。结论:采用抗生素联合强的松治疗治疗非哺乳期急性脓肿型乳腺炎较单存使用抗生素疗效满意,痊愈时间快,安全性高,值得临床推广应用。Objective： To evaluate the clinical efficacy of antibiotic combined with prednisone in acute abscess non-lactation mastitis,its impact on the peripheral blood CD^4＋/CD^8＋ratio,and the safety evaluation. Method： Breast surgery 120 case patients with acute abscess type non-lactating mastitis were treated as object of observation from June 2012 to December 2014 120,and randomly divided into two groups with 60 cases in each group; the control group were given orally amoxicillin tablets in the treatment,0.5g / times,tid; the above on basis,the observation group were given prednisolone,20 mg,bid（ after dinner）. After a counse of treatemnt for 14 days,differences of the effect between the two groups and the aduenrse erents were evaluated. Result： The effective rate 86.4%（ 51 / 59） in the observation gruop was significantly higher thathat in the control group 75.9%（ 44 / 58）,the difference was statistically significant（ P〈0.05）. And in observation group the cure rate and recovery time were better than that in the control group（ P〈0.05）. After treatment,peripheral blood CD4＋lymphocyte percentage CD^4＋/CD^8＋ratio of the two groups decreased（ all P〈0.05）,while those in the observation group decreased more significantly（ P〈0.05））; the percentage of CD-（8＋） in the observation group obviously increased（ P〈0.05）,no significant increase in the control group（ P〉0.05）,the difference was not statistically significant; CD^4＋/CD^8＋ratio in the observation group was significantly lower than that in the control group,（ P〈0. 05））,the difference is statistically significanct. There were no significant adverse reactions in the two groups. Conclusion： Compared with single antibiotics,the efficacy of antibiotic combined with prednosone in a cute abscess typ0 e non-ctating mastitis is more satisfying,,worthy of clinical application.

关 键 词：非哺乳期乳腺炎 抗生素 强的松 疗效 CD^4+/CD^8+比值 

分 类 号：R655.8[医药卫生—外科学]