万古霉素治疗心力衰竭患者肺部感染的疗效及对炎症因子的影响  

Efficacy of vancomycin in treatment of heart failure complicated with pulmonary infections and its influence on inflammatory factors

作　　者：亓俊杰[1] 刘建花[1] 周姝[1] 邢永生[1] 王津生[1] 

机构地区：[1]新乡市中心医院心血管内科,河南新乡453000

出　　处：《中华医院感染学杂志》2016年第12期2685-2687,共3页Chinese Journal of Nosocomiology

基　　金：河南省科技厅重点基金资助项目(XP20100708)

摘　　要：目的观察万古霉素治疗心力衰竭患者肺部感染的疗效并分析其对炎症因子的影响,为心力衰竭患者肺部感染治疗提供指导。方法将2013年2月-2015年6月医院收治的180例慢性心力衰竭患者肺部感染随机分为对照组和观察组,各90例,对照组给予左氧氟沙星治疗,观察组给予万古霉素治疗,比较两组患者肺炎及心力衰竭改善的差异,比较治疗前后两组患者血清炎症因子及血浆脑钠肽(BNP)水平差异,数据采用SPSS 17.0统计软件进行处理。结果心功能改善比较结果显示,观察组患者显效率和总有效率分为45.6%和83.3%,高于对照组的31.1%和68.9%,差异有统计学意义(P<0.05);肺部感染疗效比较结果显示,观察组治愈率和总有效率分别为62.2%和94.4%,高于对照组的28.9%和60.0%,差异有统计学意义(P<0.05);治疗后观察组血清白介素-6(IL-6)、IL-10、肿瘤坏死因子-α(TNF-α)和BNP水平分别为(26.2±5.2)(5.2±1.8)(8.3±3.1)g/L和(213.4±187.7)g/L,显著低于对照组的(39.7±8.9)(9.8±2.5)(13.5±3.5)g/L和(683.4±265.3)g/L,差异有统计学意义(P<0.05)。结论万古霉素能有效控制心力衰竭患者肺部感染的症状,减少炎症反应,有利于患者心功能的恢复。OBJECTIVE To observe the efficacy of vancomycin in the treatment of heart failure complicated with pulmonary infections and its influence on inflammatory factors,so as to provide guidance for patients with heart failure complicated by pulmonary infections.METHODS Totally 180 cases of patients with chronic heart failure complicated by pulmonary infections treated in the hospital during Feb.2013 to Jun.2015 were randomly divided into two groups,the control group and the observation group,each group of 90 cases.Patients in the control group used levofloxacin for infections,and those in the observation group were treated with vancomycin.Then the differences of improvement of pneumonia and heart failure between two groups were compared,and serum levels of inflammatory factors and BNP before and after treatment were compared.Data were processed by statistical software SPSS 17.0.RESULTS Comparison of cardiac function showed that the significant efficiency and the total efficiency of the observation group were 45.6% and 83.3% which were significantly higher than 31.1% and 68.9%of the control group（P〈0.05）.Comparison of pulmonary infection showed that the cure rate and the total effective rate of the observation group were 62.2% and 94.4%,higher than 28.9% and 60..0% of the control group,and the difference between groups was significant（P〈0.05）.At the end of treatment,the serum levels of IL-6,IL-10,TNF-αand BNP levels in the observation group were（26.2±5.2）g/L,（5.2±1.8）g/L,（8.3±3.1）g/L and（213.4±187.7）g/L respectively which were significantly lower than those in the control group which were（39.7±8.9）g/L,（9.8±2.5）g/L,（13.5±3.5）g/L and（683.4±265.3）g/L（P〈0.05）.CONCLUSIONVancomycin can effectively control the symptoms of infection in patients with heart failure complicated by pulmonary infections and reduce the inflammatory response,and it is conducive to the recovery of heart function.

关 键 词：心力衰竭 肺部感染 万古霉素 炎症因子 血浆脑钠肽 

分 类 号：R541.6[医药卫生—心血管疾病]