优化两步输注美罗培南联合参麦注射液对重症感染患者血清感染指标、细菌清除率和T淋巴细胞亚群的影响  

Optimization of Two-step Tnfusion of Meropenem Combined with Shenmai Injection on Serum infection Index, Bacterial Clearance Rate and T Lymphocyte Subsets in Patients with Severe Infection

作　　者：成群 吴佳妮[1] 孙建鹰[1] 高光霞 靳琳[1] 付欢 CHENG Qun;WU Jia-ni;SUN Jian-ying;GAO Guang-xia;JIN Lin;FU Huan(Department of Critical Care Medicine,The Sixth People's Hospital of Chengdu,Chengdu,Sichuan,610000,China)

机构地区：[1]成都市第六人民医院重症医学科,四川成都610000

出　　处：《现代生物医学进展》2021年第2期388-392,共5页Progress in Modern Biomedicine

基　　金：四川省卫生和计划生育委员会科研项目(17PJ1033)。

摘　　要：目的:探讨优化两步输注美罗培南联合参麦注射液对重症感染患者血清感染指标、细菌清除率和T淋巴细胞亚群的影响。方法:选取2017年1月-2018年10月在我院重症医学科(ICU)住院的153例重症感染患者,按随机数字表法将患者分为传统输注美罗培南组(A组,54例)、优化两步输注美罗培南组(B组,49例)、优化两步输注美罗培南联合参麦注射液组(C组,50例)。比较治疗后三组患者的总体疗效、血清感染指标和T淋巴细胞亚群水平及不良反应发生情况。结果:B组、C组的临床有效率、细菌清除率、28天生存率高于A组(P<0.05);B组、C组机械通气时间、ICU住院时间、总住院时间少于A组,且C组少于B组(P<0.05);治疗后B组、C组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)高于A组,且C组高于B组(P<0.05);B组、C组CD8^(+)、白细胞计数(WBC)、降钙素原(PCT)、C-反应蛋白(CRP)水平低于A组,且C组低于B组(P<0.05)。三组患者不良反应发生率比较无差异(P>0.05)。结论:优化两步输注美罗培南联合参麦注射液治疗重症感染患者疗效确切,可提高细菌清除率,改善患者免疫状态,促进患者康复。Objective: To explore the effects of optimization of two-step infusion of meropenem combined with Shenmai injection on serum infection index, bacterial clearance rate and T lymphocyte subsets in patients with severe infection. Methods: 153 patients with severe infection who were hospitalized in our intensive care unit(ICU) from January 2017 to October 2018. According to the random number table method, the patients were divided into the traditional infusion meropenem group(group A, 54 cases), the optimization of two-step infusion meropenem group(group B, 49 cases), and the optimization of two-step infusion meropenem combined with Shenmai injection group(group C, 50 cases). The overall efficacy, serum infection index, T lymphocyte subsets and adverse reactions were compared among the three groups after treatment. Results: The clinical cure rate, bacterial clearance rate and 28-day survival rate of patients in group B and group C were higher than those in group A(P<0.05). The mechanical ventilation time, ICU hospitalization time, and total hospitalization time in group B and group C were less than those in group A, and those in group C were less than those in group B(P<0.05).After treatment, the levels of CD3^(+), CD4^(+), CD4^(+)/CD8^(+)in group B and group C were higher than those in group A, and those in group C were higher than those in group B(P<0.05). The levels of CD8^(+), white blood cell(WBC), pro-calcitonin(PCT) and C-reactive protein(CRP) in group B and group C were lower than those in group A, and those in group C were lower than those in group B(P<0.05). There was no significant difference in the incidence of adverse drug reactions among the three groups(P>0.05). Conclusions: Optimization of two-step infusion of meropenem combined with Shenmai injection in the treatment of patients with severe infection is effective. It can improve the bacterial clearance rate, improve the immune status of patients, and it can promote the rehabilitation of patients.

关 键 词：美罗培南 参麦注射液 感染指标 细菌清除率 T淋巴细胞亚群 重症感染 

分 类 号：R63[医药卫生—外科学] R459.7[医药卫生—临床医学]