热毒宁联合头孢哌酮/舒巴坦钠和替加环素对泛耐药鲍氏不动杆菌肺炎的抑菌效果  

Antibacterial effect of Reduning combined with cefoperazone/sulbactam sodium and tigecycline on extensively drug-resistant Acinetobacter baumannii

作　　者：林昱 汪华[2] 李鹏[3] LIN Yu;WANG Hua;LI Peng(Hospital of joint logistics support force,Baoji,Shaanxi 721004,China;不详)

机构地区：[1]联勤保障部队第九八七医院药剂科,陕西宝鸡721004 [2]陕西省宝鸡市中心医院肿瘤内科,陕西宝鸡721008 [3]陕西省宝鸡市中心医院普通外科,陕西宝鸡721008

出　　处：《中华医院感染学杂志》2022年第3期331-335,共5页Chinese Journal of Nosocomiology

基　　金：军队中医药专项科研基金资助项目(10ZYX108)。

摘　　要：目的探讨热毒宁联合头孢哌酮/舒巴坦钠和替加环素对泛耐药鲍氏不动杆菌(XDRAB)肺炎的联合抑菌效果。方法选取2017年5月-2020年3月联勤保障部队第九八七医院收治的88例XDRAB肺炎患者,根据随机数字表法分为研究组和对照组,各44例。常规治疗基础上,对照组给予头孢哌酮/舒巴坦钠和替加环素,研究组给予热毒宁联合头孢哌酮/舒巴坦钠和替加环素。比较两组细菌清除率、总有效率、体温恢复时间、咳嗽缓解时间、感染控制窗出现时间、急性生理和慢性健康状况评分(APACHEⅡ)、临床肺部感染(CPIS)评分、炎症反应相关指标[C-反应蛋白(CRP)、白细胞计数(WBC)、降钙素原(PCT)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]、体液免疫[免疫球蛋白M(IgM)、IgG、IgA]、细胞免疫[CD_(3)^(+)、CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)、自然杀伤(NK)细胞]和安全性。结果研究组细菌清除率、总有效率优于对照组(P<0.05)。研究组体温恢复时间、咳嗽缓解时间、感染控制窗出现时间短于对照组(P<0.05)。治疗后研究组APACHEⅡ评分、CPIS评分低于对照组(P<0.05);研究组治疗后CRP、WBC、PCT、IL-6、TNF-α低于对照组(P<0.05)。研究组治疗后IgM、IgG、IgA、CD_(3)^(+)、CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)、NK细胞高于对照组(P<0.05);两组不良反应发生率比较,无统计学差异。结论热毒宁联合头孢哌酮/舒巴坦钠和替加环素通过降低炎症反应,调节免疫功能,利于提高联合抑菌效果,促进XDRAB肺炎患者预后改善,且具有一定安全性。OBJECTIVE To study the combined antibacterial effect of Reduning combined with cefoperazone/sulbactam sodium and tigecycline on extensively drug resistant Acinetobacter baumannii(XDRAB).METHODS Total of 88 patients with XDRAB pneumonia admitted to the 987 th Hospital of the People′s Liberation Army Joint Logistic Support Force between May 2017 and Mar 2020 were divided into the study group and control group by using random number table method,44 cases in each group.On the basis of conventional treatment,the control group was given intravenous administration of cefoperazone/sulbactam sodium and tigecycline,and the study group was given intravenous administration of reduning combined cefoperazone/sulbactam sodium and tigecycline.Bacteria clearance rates,total effective rates,body temperature recovery time,cough relief time,infection control window appearance time,acute physiology and chronic health scores(APACHEⅡ),clinical lung infection(CPIS)scores,inflammatory response related indicators including C-reactive protein(CRP),white blood cell count(WBC),procalcitonin(PCT),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),humoral immunity related factors such as immunosphere Protein M(IgM),IgG and IgA,cellular immunity related factors including CD_(3)^(+),CD_(4)^(+),CD_(4)^(+)/CD_(8)^(+),natural killer(NK)cells,and drug safety between the two groups were compared.RESULTS The bacterial clearance rate and total effective rate in the study group were significantly better than those in the control group(P<0.05).The body temperature recovery time,cough relief time,and appearance time of infection control window in the study group were significantly shorter than those in the control group(P<0.05).After treatment,the APACHEⅡand CPIS scores,CRP,WBC,PCT,IL-6,and TNF-αin the study group were significantly lower than those in the control group(P<0.05).After treatment,IgM,IgG,IgA,CD_(3)^(+),CD_(4)^(+),CD_(4)^(+)/CD_(8)^(+),and NK cells in the study group were significantly higher than those in the control group(P<0.05).T

关 键 词：热毒宁 头孢哌酮/舒巴坦钠 替加环素 泛耐药鲍氏不动杆菌肺炎 细菌清除率 

分 类 号：R978[医药卫生—药品]