社区获得性肺炎抗感染疗效及降钙素原和超敏C-反应蛋白的水平变化研究  

Efficacy of anti-infection treatment of community-acquired pneumonia and changes of procalcitonin and high-sensitivity C-reactive protein levels

作　　者：孙光胜[1] 王志英[1] 鲍洪雅 骆晓兰 朱巍[1] 

机构地区：[1]绍兴文理学院附属医院呼吸内科,浙江绍兴312000

出　　处：《中华医院感染学杂志》2017年第10期2202-2205,共4页Chinese Journal of Nosocomiology

基　　金：浙江省医药卫生科技计划基金资助项目(2013ZHB0111)

摘　　要：目的探讨社区获得性肺炎(CAP)的抗感染疗效,观察炎症因子降钙素原(PCT)和超敏C-反应蛋白(hsCRP)在抗感染治疗前后的水平变化规律。方法选取2015年1-12月医院收治的死亡风险中等的CAP患者60例,依据抗感染方式的不同,分为左氧氟沙星组30例和β-内酰胺类联合阿奇霉素组(联合治疗组)30例,监测患者入院时、治疗期间生命体征变化,以及入院第3天及第5天血常规、血hs-CRP和PCT水平,比较两组患者治疗前后生命体征、血常规、PCT、hs-CRP、平均住院时间的差异。结果两组患者在性别、年龄及入院时生命体征(体温、呼吸、心率)方面比较,差异均无统计学意义(P>0.05);随着抗感染时间的延长,左氧氟沙星组患者体温恢复正常时间短于联合治疗组(P<0.05),其余生命体征指标恢复正常时间差异无统计学意义;两组患者入院时血常规、hs-CRP和PCT水平比较差异无统计学意义,入院第3天左氧氟沙星组较联合治疗组在白细胞计数(WBC)、中性粒细胞、单核细胞恢复正常的百分率比较,差异均有统计学意义(P<0.05);入院第5天时hs-CRP恢复正常的百分率高于联合治疗组(P<0.05)。结论与β-内酰胺类联合阿奇霉素治疗相比,左氧氟沙星治疗中度CAP患者的临床疗效似乎更好,多伴有血白细胞和炎症因子hs-CRP的更多改善。OBJECTIVE To explore the efficacy of anti-infection treatment of community-acquired pneumonia （CAP）and observe the changes of levels of inflammatory factors procalcitonin （PCT） and high-sensitivity C-reactive protein （hs-CRP） before and afteer the anti-infection treatment.METHODS A total of 60 CAP patients who were at moderate risk of death and were treated in the hospital from Jan 2015 to Dec 2015 were enrolled in the study.The enrolled patients were divided into the levofloxacin group with 30 cases and the β-lactams combined with azithromycin group （the combined treatment group） with 30 cases.The vital signs of the patients were monitored at the admission to hospital and during the treatment period,the levels of blood routine,serum hs-CRP,and PCT were also monitored on Day 3 and Day 5 of admission;the viral signs,levels of blood routine,PCT and hs-CRP,and mean hospitalization duration were observed and compared between the two groups of patients.RESULTS There was no significant difference in the genders,age,or vital signs at the admission （body temperature,breath,heart rate） between the two groups of patients （P〉0.05）.With the time of anti-infection treatment,the time of body temperature returning to normal was significantly shorter in the levofloxacin group than in the combined treatment group （P〈0.05）,while there was no significant difference in the time of the rest of vital signs indexes returning to normal.There was no significant difference in the level of blood routine,hs-CRP,or PCT between the two groups of patients at the admission.There was significant difference in the percentage of white blood cell （WBC）counts,neutrophils,or monocyte returning to normal between the levofloxacin group and the combined treatment group on Day 3 of admission （P〈0.05）.The percentage of hs-CRP returning to normal of the levofloxacin group was higher than that of the combined treatment group （P〈0.05）.CONCLUSION Compared with β-lactams combined with azithromycin,levofloxacin

关 键 词：社区获得性肺炎 左氧氟沙星 阿奇霉素 降钙素原 超敏C-反应蛋白 

分 类 号：R563.1[医药卫生—呼吸系统]