硫酸头孢噻利和头孢吡肟对卒中相关性肺炎的疗效评价  

Study on therapeutic effect of Cefoselis sulfate versus Cefepime on stroke-associated pneumonia in elderly patients

作　　者：何静春[1] 林展增[1] 李立宇[1] 井军虎[1] 张媛[1] 王利军[2] 

机构地区：[1]天津医科大学第四中心临床学院呼吸一病区,300140 [2]天津医科大学第四中心临床学院神经内一科,300140

出　　处：《中华老年医学杂志》2016年第9期956-959,共4页Chinese Journal of Geriatrics

摘　　要：目的探讨硫酸头孢噻利和头孢吡肟对卒中相关性肺炎患者的治疗效果。方法将96例病原学阳性的卒中相关性肺炎患者分为两组，分别进行头孢噻利和头孢吡肟感染治疗，观察比较治疗前后体温、白细胞计数、动脉血氧分压、C反应蛋白（CRP）的变化及细菌清除率。结果患者经头孢噻利和头孢毗肟治疗后，细菌清除率分别达89．6％和67．9％。头孢噻利组显效30例、有效12例，总有效率87．5％；头孢吡肟组显效20例、有效20例，总有效率83．3％。两组患者治疗前后比较均体温下降，白细胞计数、中性粒细胞比值、CRP值下降，动脉血氧分压升高，差异均有统计学意义（均P〈0．05）；头孢吡肟组与头孢噻利组患者治疗后进行比较白细胞计数、中性粒细胞比值、CRP、动脉血氧分压差异无统计学意义（t=0．113、0．781、-0．947、-1．582、-1．845，P=0．911、0．445、0．262、0．386、0．132）。结论头孢噻利和头孢吡肟治疗卒中相关性肺炎的临床效果相当，但头孢噻利组在细菌清除率、总有效率略优于头孢吡肟组，头孢噻利更能有效清除致病菌，提高临床治疗效果。Objective To explore the therapeutic effect of Cefoselis sulfate and Cefepime on the stroke-associated pneumonia in elderly patients. Methods 96 cases of stroke-associated pneumonia with positive pathogen were divided into two groups treated with Cefoselis versus Cefepime respectively. Body temperature,leukocyte count, arterial partial oxygen pressure, the serum level of C reactive protein （CRP） and bacterial clearance rate were observed before and after the treatment. The cefoselis sulfate group （n=48 ） or the cefepime group （n： 48） was treated with 2.0 g Cefoselis sulfate or 2.0 g Cefepime every 12 hours for 7 to 10 days. Results In post treatment versus pre- treatment, both two groups showed that clinical symptoms and inflammatory indicators were improved, and the patient＇s body temperature, white blood cell count and neutrophil cell count, hs-CRP and arterial partial oxygen pressure were significantly decreased （all P〈0.05）. Arterial partial oxygen pressure was better in post- versus pre-treatment （P〈0.05）. The total effective rate was 87.5 %~ in Cefoselis sulfate group and 83.3 % in cefepime group （P 〉 0.05）. The bacterial clearance rate was higher （89.6%） in Cefoselis sulfate groups than in cefepime groups （67.9%） （P〈0. 05）. In post- treatments of Cefoselis sulfate groups versus Cefepime groups, white blood cell count and neutrophil cell count,hs-CRP and arterial partial oxygen pressure showed no statistically significant differences （all P 〉 0.05）. Conclusions Compared with Cefepime, Cefoselis has the similar anti infection efficacy in the treatment of stroke-associated pneumonia. While, the bacterial clearance rate and the total effective rate are better in cefoselis group than in Cefepime group.

关 键 词：肺炎 卒中 头孢菌素类 

分 类 号：R743.3[医药卫生—神经病学与精神病学]