人免疫球蛋白联合哌拉西林钠他唑巴坦钠治疗重症肺部感染的临床研究  

Clinical study on immunoglobulin combined with piperacillin sodium and tazobactam sodium in treatment of severe pulmonary infection

作　　者：翟静[1] 李向欣[1] 赵鹏程[1] ZHAI Jing;LI Xiang-xin;ZHAO Peng-cheng(Department of Pneumology,Beijing Changping District Hospital,Beijing 102200,China)

机构地区：[1]北京市昌平区医院呼吸科,北京102200

出　　处：《现代药物与临床》2018年第8期1954-1959,共6页Drugs & Clinic

摘　　要：目的探讨人免疫球蛋白联合哌拉西林钠他唑巴坦钠治疗重症肺部感染的临床效果。方法选取2016年6月—2017年10月北京市昌平区医院收治的60例重症肺部感染患者,随机分为对照组(30例)和治疗组(30例)。对照组患者静脉滴注注射用哌拉西林钠他唑巴坦钠3.75 g/次,12次/h,30~40 min滴完;治疗组患者在对照组的基础上静脉滴注静注人免疫球蛋白(pH4),400 mg/kg,1次/d,两组患者均治疗7 d。观察两组患者的临床疗效,比较治疗前后两组患者临床指标改善时间、肺功能、血清学指标和病情严重程度标志物水平。结果治疗后,对照组临床有效率为86.67%,显著低于治疗组的93.33%,两组比较差异具有统计学意义(P<0.05)。治疗后,治疗组咳嗽消失时间、体温恢复正常时间、肺部啰音消失时间、白细胞恢复时间、住院时间均显著短于对照组,两组比较差异有统计学意义(P<0.05)。两组血清C反应蛋白(CRP)、白介素-6(IL-6)、肿瘤坏死因子α(TNF-α)水平均显著降低,同组治疗前后比较差异具有统计学意义(P<0.01);且治疗后治疗组血清指标水平均显著低于对照组,两组比较差异有统计学意义(P<0.05)。两组血清血管紧张素转换酶(ACE)、一氧化氮(NO)水均显著降低,胆碱酯酶(ChE)水平显著升高,同组治疗前后比较差异具有统计学意义(P<0.01);且治疗后治疗组病情严重程度标志物水平显著优于对照组,两组比较差异有统计学意义(P<0.05)。结论人免疫球蛋白联合哌拉西林钠他唑巴坦钠治疗重症肺部感染效果显著,在改善肺功能、抑制炎症反应、抑制病情促进因子等方面均有积极作用,具有一定的临床推广应用价值。Objective To explore the clinical effect of immunoglobulin combined with piperacillin sodium and tazobactam sodium in treatment of severe pulmonary infection. Methods Patients（60 cases） with severe pulmonary infection in Beijing Changping District Hospital from June 2016 to October 2017 were divided into the control group（30 cases） and treatment group（30 cases） based on different treatments. Patients in the control group were iv administered with Piperacillin Sodium and Tazobactam Sodium for injection, 3.75 g/time, once per 12 h, for 30 — 40 min. Patients in the treatment group were iv administered with Human Immunoglobulin（pH 4） for intravenous injection on the basis of the control group, 400 mg/kg, once daily. Patients in two groups were treated for 7 d. After treatment, the clinical efficacy was evaluated, and the disappearance time of clinical symptoms, lung function, the serological indexes, and the markers of illness severity in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 86.67%, which was significantly lower than 93.33% in the treatment group, and there were differences between two groups（P〈 0.05）. After treatment, the disappearance time of coughing and lung rale, recovery normal of body temperature and leukocyte, and hospitalization time in the treatment group was significantly shorter than that in the control group（P〈 0.05）. After treatment, the CRP, IL-6 and TNF-α levels in two groups were significantly decreased, and there were differences in the same group（P〈 0.01）. And the serological indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups（P〈 0.05）. After treatment, the ACE and NO levels in two groups were significantly decreased, but Ch E was significantly increased, and there were differences in the same group（P〈 0.01）. And the markers of illness severity in the treatment group were significa

关 键 词：静注人免疫球蛋白(pH 4) 注射用哌拉西林钠他唑巴坦钠 重症肺部感染 肺功能 血清学指标血清血管紧张素转换酶 一氧化氮 胆碱酯酶 

分 类 号：R974[医药卫生—药品]