硫酸头孢噻利对脓毒症患者肝功能指标谷草转氨酶与谷丙转氨酶的影响  

Effects of cefoselis sulfate on liver function indexes alanine aminotransferase and aspartate aminotransferase in patients with sepsis

作　　者：李爱林[1] 袁鼎山[1] 包玉华[2] 蒋海燕[1] LI Ailin;YUAN Dingshan;BAO Yuhua;JIANG Haiyan(Department of Emergency,Nantong University Affiliated Hospital,Nantong 226001,China;Department of General Medicine,Nantong University Affiliated Hospital,Nantong 226001,China)

机构地区：[1]南通大学附属医院急诊内科,南通226001 [2]南通大学附属医院全科医学科,南通226001

出　　处：《西北药学杂志》2021年第2期288-292,共5页Northwest Pharmaceutical Journal

基　　金：国家自然科学基金项目(编号:81801893)。

摘　　要：目的探讨硫酸头孢噻利对脓毒症患者肝功能指标谷丙转氨酶(ALT)和谷草转氨酶(AST)的影响。方法选择脓毒症患者127例,分为头孢哌酮组(头孢哌酮治疗)63例,联合组(头孢哌酮联合硫酸头孢噻利治疗)64例,观察2组脓毒症休克原发感染部位;记录2组治疗前、后生命体征变化;比较2组治疗前、后ALT、AST水平变化以及慢性健康状况(APACHE)和序贯器官衰竭评估(SOFA)评分变化。结果2组下呼吸道感染人数均较多,头孢哌酮组有22例,联合组有24例,头孢哌酮组创伤、皮肤感染人数均为12例,联合组分别为6、8例,2组患者原发感染部位人数比较差异无统计学意义(χ2=4.948,P=0.551);2组治疗前相关炎性因子水平比较差异无统计学意义(P>0.05)。2组治疗后超敏C反应蛋白(hs-CRP)、肿瘤坏死因子(TNF-α)和白细胞介素-6(IL-6)水平均低于治疗前(P<0.05),与头孢哌酮组治疗后比较,联合组TNF-α、hs-CRP和IL-6水平均明显降低(P<0.05);治疗前2组ALT和AST水平比较差异无统计学意义(P>0.05),治疗后2组ALT和AST水平均低于治疗前(P<0.05),与头孢哌酮组治疗后比较,联合组ALT和AST水平均显著下降(P<0.05);治疗前2组APACHE、SOFA评分比较差异无统计学意义(P>0.05),治疗后2组APACHE和SOFA评分均低于治疗前(P<0.05);与头孢哌酮组治疗后比较,联合组APACHE和SOFA评分均显著下降(P<0.05);治疗前2组白细胞计数(WBC)、心率(HR)、呼吸频率(RR)、体温比较差异均无统计学意义(P>0.05),治疗后2组WBC、HR、RR和体温均低于治疗前(P<0.05),与头孢哌酮组治疗后比较,联合组治疗后WBC、HR和RR均明显下降(P<0.05),体温无明显变化。结论硫酸头孢噻利联合头孢哌酮对脓毒症有明显的治疗作用,能改善患者肝功能相关指标ALT和AST水平。Objective To investigate the effects of cefoselis sulfate on liver function indexes alanine aminotransferase(ALT)and aspartate aminotransferase(AST)in patients with sepsis.Methods 127 patients with sepsis were selected and divided into cefoperazone group(cefoperazone treatment)63 cases,combined group(cefoperazone combined with cefoselis sulfate treatment)64 cases.The septic shock of primary infection site of 2 group was observed.The changes of vital signs before and after treatment in the 2 groups were recorded;the changes in ALT and AST levels and the changes in acute physiology and chronic health evaluation scoring system(APACHE)and sequential organ failure assessment(SOFA)scores before and after treatment in the 2 groups were compared.Results There were a large number of lower respiratory tract infections.There were 22 cases in the cefoperazone group and 24 cases in the combination group.The number of trauma and skin infections in the cefoperazone group were both 12,and the number in the combination group was 6 and 8 cases,respectively.There was no significant difference in the number of people(χ2=4.948,P=0.551);there was no significant difference in the levels of related inflammatory factors between the 2 groups before treatment(P>0.05).After treatment high sensitivity C-reactive protein(hs-CRP),tumor necrosis factor(TNF-α),interleukin-6(IL-6)levels after treatment in the 2 groups were lower than before treatment(P<0.05).Compared with the piperone group after treatment,the levels of TNF-α,hs-CRP and IL-6 in the combination group were significantly reduced(P<0.05);there was no significant difference in ALT and AST levels between the 2 groups before treatment(P>0.05).The ALT and AST levels of the 2 group after treatment were lower than before treatment(P<0.05).Compared with the cefoperazone group after treatment,the ALT and AST levels of the combination group decreased significantly(P<0.05);APACHE and SOFA showed no statistically significant difference in the score values in the 2 groups before treatment(P>0

关 键 词：头孢哌酮 硫酸头孢噻利 脓毒症 谷丙转氨酶(ALT) 谷草转氨酶(AST) 肝功能 

分 类 号：R975[医药卫生—药品]