痰热清注射液联合抗生素对脑卒中并发肺部感染患者的治疗效果  

Effect of Tanreqing injection combined with antibiotics on treatment of patients with stroke and pulmonary infection

作　　者：程丽[1] 顾岩[1] 徐磊[1] 成忠红[1] 郭丽平[1] CHENG Li;GU Yan;XU Lei;CHENG Zhong-hong;GUO Li-ping(Inner Mongolia Medical University Affiliated Hospitals Hohhot Inner Mongolia 010050,China)

机构地区：[1]内蒙古医科大学附属医院呼吸与危重症医学科

出　　处：《中华医院感染学杂志》2019年第24期3769-3772,3803,共5页Chinese Journal of Nosocomiology

基　　金：呼和浩特市医药卫生科技发展计划基金资助项目(2017279)

摘　　要：目的探究痰热清注射液联合抗菌药物对脑卒中并发肺部感染患者治疗效果及对预后的影响。方法选取2016年5月-2017年6月经内蒙古医科大学附属医院诊治的脑卒中并发肺部感染患者120例,根据随机数表法分为试验组和对照组,每组60例。对照组患者根据药物敏感试验给予适宜抗菌药物治疗,试验组患者在对照组的基础上加用痰热清注射液静脉滴注治疗,疗程均为2周。比较两组患者治疗前后降钙素原(Procalcitonin,PCT)、C-反应蛋白(C-reactive protein,CRP)、肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)水平。比较两组患者咳嗽、发热、白细胞计数、肺部啰音等各项临床指标改善时间及住院时间和生存时间。观察两组患者临床疗效及1年内病死情况。结果治疗后,两组患者血清TNF-α、PCT、CRP水平较治疗前低(P<0.05),但试验组TNF-α、PCT、CRP水平较对照组低(P<0.05);试验组咳嗽缓解时间、白细胞计数恢复时间、肺部啰音消失时间、退热时间及住院时间均较对照组短(P<0.05);试验组临床疗效总有效率为91.67%,高于对照组的76.67%(P<0.05);试验组1年病死率为1.67%,低于对照组的15.00%(P<0.05),平均生存时间为(18.65±4.75)个月,高于对照组(13.53±3.46)个月(P<0.05)。结论痰热清注射液联合抗菌药物治疗脑卒中并发肺部感染的疗效较好,可改善患者机体炎症反应,提高患者生存预后。OBJECTIVE To explore the effect of Tanreqing injection combined with antibiotics on treatment of the stroke patients with pulmonary infection and the influence on prognosis. METHODS A total of 120 patients with stroke complicated with pulmonary infection were recruited in the Affiliated Hospital of Inner Mongolia Medical University from May 2016 to June 2017. They were divided into the experimental group and the control group according to random number tables, 60 cases in each group. The patients in the control group were given appropriate antimicrobial drugs according to the drug sensitivity test. The patients in the experimental group were given Tanreqing injection intravenously on the basis of the control group for 2 weeks. The levels of procalcitonin(PCT), C-reactive protein(CRP) and Tumor necrosis factor-α(TNF-α) were compared between the two groups before and after treatment. The improvement time of cough, fever, white blood cell count, lung rale and other clinical indicators, hospital stay and survival time were compared between the two groups. The clinical efficacy and mortality in one year were observed in the two groups. RESULTS The serum levels of TNF-α, PCT and CRP in the two groups after the treatment were significantly lower than those before the treatment(P<0.05), but the levels of TNF-α, PCT and CRP in the experimental group were significantly lower than those in the control group(P<0.05). The cough relief time, recovery time of white blood cell count, disappearance time of lung rales, antipyretic time and hospitalization time in the experimental group were significantly shorter than those in the control group(P<0.05). The total effective rate of the experimental group was 91.67%, which is significantly higher than that of the control group(76.67%)(P<0.05). The one-year mortality rate of the experimental group was 1.67%,which is significantly lower than that of the control group(15.00%)(P<0.05). And the average survival time was(18.65±4.75) months, which was significantly higher than that of

关 键 词：痰热清注射液 抗菌药物 脑梗死 脑出血 肺部感染 炎症反应 预后 

分 类 号：R563.1[医药卫生—呼吸系统]