美罗培南治疗重症肺炎的疗效及对炎症指标和免疫功能的影响  

Influence of Meropenem in the Treatment of Severe Pneumonia and Its Effect on Inflammatory Indexes and Immune Function

作　　者：肖淑娜 孟亚磊 赵宏巧[1] XIAO Shu-na;MENG Ya-lei;ZHAO Hong-qiao(Department of Pharmacy,The First Affiliated Hospital of Henan University of Science and Technology,Luoyang471003)

机构地区：[1]河南科技大学第一附属医院药学部,洛阳471003

出　　处：《实用中西医结合临床》2022年第10期11-15,共5页Practical Clinical Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的:探讨美罗培南(MER)治疗重症肺炎的疗效及对机体炎症指标和免疫功能的影响。方法:选取2019年1月至2021年6月进行治疗的重症肺炎患者105例,按照随机数字表法分为MER组(n=53)和对照组(n=52),对照组采用常规抗炎及支持治疗,MER组在对照组基础上联合MER静滴治疗,比较两组总体疗效、血清感染指标、T淋巴细胞亚群及免疫球蛋白水平。结果:治疗后MER组临床总有效率、28 d生存率、细菌清除率均高于对照组,机械通气时间、住院时间均低于对照组(P<0.05);治疗后两组血清降钙素原(PCT)、C反应蛋白(CRP)均降低,且MER组低于对照组(P<0.05);治疗后两组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)均升高,CD8^(+)均降低,且MER组变化较对照组更明显(P<0.05);两组血清免疫球蛋白A(IgA)、免疫球蛋白G(IgG)、免疫球蛋白M(IgM)及补体C3、C4水平治疗前后、组间对比均无明显差异(P>0.05)。结论:MER治疗重症肺炎疗效确切,且能提高外周血CD4^(+)T淋巴细胞亚群比例、降低机体炎症反应强度。Objective:To investigate the effect of meropenem(MER)in the treatment of severe pneumonia and its effection inflammation and immune function.Methods:From January 2019 to June 2021,a total of 105 patients with severe pneumonia were selected and divided into MER group(n=53)and control group(n=52)according to random number table method.The control group was treated with routine anti-inflammatory and supportive treatment,and the MER group was treated with MER intravenous drip on the basis of the treatment of the control group.After treatment,the overall efficacy,serum infection indicators,T lymphocyte subsets and immunoglobulin levels of the two groups were compared.Results:After treatment,the total clinical effective rate,28 day survival rate and bacterial clearance rate of mer group were higher than those of the control group,while the time of mechanical ventilation and hospitalization were lower than those of the control group(P<0.05);the levels of serum procalcitonin(PCT)and C-reactive protein(CRP)in the two groups decreased,and those indexes in the MER group were lower than those in the control group(P<0.05);CD3^(+),CD4^(+),CD4^(+)/CD8^(+)increased and CD8^(+)decreased in both groups,and the change in MER group was more obvious than those in control group(P<0.05);there were no differences in the levels of serum immunoglobulin A(IgA),immunoglobulin G(IgG),immunoglobulin M(IgM)and complement C3 and C4 between the two groups before and after treatment(P>0.05).Conclusion:MER is effective in the treatment of severe pneumonia,it can increase the proportion of CD4^(+)T lymphocytes subsets in peripheral blood and reduce the intensity of the body's inflammatory response.

关 键 词：重症肺炎 美罗培南 炎症指标 T淋巴细胞亚群 免疫球蛋白 

分 类 号：R563.1[医药卫生—呼吸系统]