治疗急性气管支气管炎致剧烈咳嗽的抗菌药物选用及疗效  

Selection and efficacy of antibiotics for severe cough caused by acute tracheal bronchitis

作　　者：朱选风 高兆芳 刘剑南 顾建华 ZHU Xuanfeng;GAO Zhaofang;LIU Jiannan;GU Jianhua(Chronic Airway Disease Lab,Geriatric Hospital of Nanjing Medical University,Training Hospital of Jiangsu Health Vocational College,Nanjing 210024,China;Planned Immunology,Hebei Province Centers for Disease Control and Prevention,Qinhuangdao 066000,China)

机构地区：[1]南京医科大学附属老年医院慢性气道疾病研究室,江苏卫生健康职业学院驻点教学医院,南京210024 [2]河北省秦皇岛市疾病预防控制中心免疫科,秦皇岛066000

出　　处：《西北药学杂志》2019年第5期657-660,共4页Northwest Pharmaceutical Journal

基　　金：国家自然科学基金面上项目(编号:81470273);江苏省科技厅临床医学科技专项(编号:BL2014083);呼吸疾病国家重点实验室开放课题(编号:201216);江苏省六大人才高峰项目(编号:WSW-029);2018年江苏卫生健康职业学院院级科研项目(编号:JKFY201810)

摘　　要：目的研究克拉霉素、头孢羟氨苄及左氧氟沙星对急性气管支气管炎致剧烈咳嗽患者的临床疗效及选药。方法将328例患者随机分成3组,第1组113例口服克拉霉素,第2组109例口服头孢羟氨苄,第3组106例口服左氧氟沙星。结果克拉霉素组、头孢羟氨苄组和左氧氟沙星组的有效率分别为62.83%,33.03%和64.15%;在<60岁的患者中,克拉霉素组的有效率为71.2%,明显高于头孢羟氨苄组(36.9%)和左氧氟沙星组(58.1%)(P<0.01)。在≥60岁的患者中,左氧氟沙星组的有效率为72.7%,明显高于头孢羟氨苄组(27.3%)和克拉霉素组(47.5%)(P<0.01)。在<60岁的患者人群中,克拉霉素对干咳、家人有咳嗽、单核细胞计数增高和血小板压积降低等有效率高;头孢羟氨苄对咳黄痰和白细胞总数增高等有效率高;在≥60岁患者人群中,左氧氟沙星对咳嗽、白细胞总数增高、单核细胞计数增高和血小板压积降低等有效率高。结论为了提高有效率,应根据患者的临床特点和可能的病原菌选择靶向抗菌药物。Objective To study the clinical effect and drug selection of clarithromycin,cefadroxil and levofloxacin on acute bronchitis induced severe cough.Methods 328 patients were randomly divided into 3 groups:group 1(113 cases)took clarithromycin,group 2(109 cases)cefadroxil and group 3(106 cases)levofloxacin.Results The effective rates of clarithromycin group,cefadroxil group and levofloxacin group were 62.83%,33.03%and 64.15%,respectively.The effective rate of clarithromycin group(71.2%)was significantly higher than that of cefadroxil group(36.9%)and levofloxacin group(58.1%)in patients<60 years old(P<0.01).The effective rate of levofloxacin group(72.7%)was significantly higher than that of cefadroxil group(27.3%)and clarithromycin group(47.5%)in patients≥60 years old(P<0.01).The effective rate of clarithromycin therapy was higher in patients<60 years old with dry cough and family cough,increased monocyte count and decreased platelet hematocrit.The effective rate of cefadroxil in patients with cough yellow phlegm and increased white blood cell count was higher.The effective rate of levofloxacin was higher in patients with cough,increased white blood cell count,increased monocyte count,reduced platelet pressure and age≥60 years old patients.Conclusion In order to improve the effective rate,the target antibiotics should be selected according to the clinical characteristics of the patients and the possible pathogenic bacteria.

关 键 词：克拉霉素 头孢羟氨苄 左氧氟沙星 急性气管支气管炎 咳嗽 

分 类 号：R974[医药卫生—药品]