哌拉西林舒巴坦联合左旋咪唑治疗高龄糖尿病并重症肺炎对照研究  

A control study of piperacillin and sulbactam combined with levamisole in the treatment of elderly diabetes with severe pneumonia

作　　者：任保仙[1] 魏晓华[1] 刘明哲[1] 田德增[1] Ren Baoxian;Wei Xiaohua;Liu Mingzhe;Tian Dezeng(Anyang District Hospital,Anyang 455000,Henan,China)

机构地区：[1]濮阳市安阳地区医院,河南安阳455000

出　　处：《临床心身疾病杂志》2021年第6期11-16,共6页Journal of Clinical Psychosomatic Diseases

基　　金：河南省医学科技攻关计划项目(编号201808269)。

摘　　要：目的探讨哌拉西林舒巴坦联合左旋咪唑治疗高龄糖尿病并重症肺炎的疗效及对患者免疫功能、炎症因子水平的影响。方法将112例高龄糖尿病并重症肺炎患者按随机数字表法分为研究组(56例)、对照组(56例)。在常规治疗的基础上,对照组予以哌拉西林舒巴坦治疗,研究组给予哌拉西林舒巴坦联合左旋咪唑治疗,观察2周。比较两组疗效、不良反应发生率、住院时间、机械通气率、住院死亡率,治疗前后序贯器官衰竭评估评分、急性生理学和慢性健康状况评分系统Ⅱ评分、血清免疫功能指标(CD8+、CD4+、CD4+/CD8+、自然杀伤细胞)、炎症因子指标(白细胞介素-6、C反应蛋白、降钙素原)水平。结果研究组总有效率显著高于对照组(P<0.05)。治疗后两组序贯器官衰竭评估、急性生理学和慢性健康状况评分系统Ⅱ评分较治疗前显著降低(P<0.01),研究组显著低于对照组(P<0.01)。治疗后两组血清CD8+水平较治疗前显著降低(P<0.01),研究组显著低于对照组(P<0.01),两组血清CD4+、CD4+/CD8+、自然杀伤细胞水平较治疗前显著增高(P<0.01),研究组显著高于对照组(P<0.01)。治疗后两组血清白细胞介素-6、C反应蛋白、降钙素原水平较治疗前显著降低(P<0.01),研究组显著低于对照组(P<0.01)。研究组住院时间显著短于对照组(P<0.01),住院死亡率显著低于对照组(P<0.01)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论哌拉西林舒巴坦联合左旋咪唑治疗高龄糖尿病并重症肺炎疗效显著,可改善患者免疫功能,减轻炎症反应,安全性高。Objective To investigate the efficacy of piperacillin and sulbactam combined with levamisole in the treatment of elderly diabetes with severe pneumonia and its effect on immune function and inflammatory factors in patients.Methods A total of 112 elderly patients with diabetes and severe pneumonia were divided into study group(56 cases)and control group(56 cases)according to random number table method.On the basis of conventional treatment,the control group was treated with piperacillin and sulbactam,and the study group was treated with piperacillin and sulbactam combined with levamisole foR2 weeks.The efficacy,incidence of adverse reactions,length of stay,mechanical ventilation rate,in-hospital mortality,sequential organ failure assessment(SOFA)score,acute physiology and chronic health evaluationⅡ(APACHEⅡ)score,serum immune function indexes(CD8+,CD4+,CD4+/CD8+,NK cells)and inflammatory factor indexes[interleukin-6(IL-6),C-reactive protein(CRP),procalcitonin(PCT)]before and after treatment were compared between the two groups.Results The total effective rate of study group was significantly higher than that of control group(P<0.05).After treatment,SOFA and APACHEⅡscores in the two groups were significantly lower than those before treatment(P<0.01),and those in the study group were significantly lower than those in the control group(P<0.01).After treatment,the levels of serum CD8+in the two groups were significantly lower than those before treatment(P<0.01),the study group was significantly lower than the control group(P<0.01).The levels of serum CD4+,CD4+/CD8+and NK cells in the two groups were significantly higher than those before treatment(P<0.01),the study group was significantly higher than the control group(P<0.01).After treatment,the levels of IL-6,CRP and PCT in the two groups were significantly lower than those before treatment(P<0.01),and those in the study group were significantly lower than those in the control group(P<0.01).The length of stay in the study group was significantly shorter than tha

关 键 词：糖尿病 重症肺炎 高龄 左旋咪唑 哌拉西林舒巴坦 免疫功能 

分 类 号：R587.1[医药卫生—内分泌] R563.1[医药卫生—内科学]