头孢哌酮/舒巴坦联合替加环素对耐碳青霉烯类鲍曼不动杆菌感染患者APACHE Ⅱ评分及炎症反应的影响  

Effect of Cefoperazone/Sulbactam Combined with Tegacyclin on APACHE Ⅱ Score and Inflammatory Response in Patients with Carbapenem Resistant Acinetobacter Baumannii Infection

作　　者：王龙梅[1] 高志凌[1] 尹硕淼 李魏[1] 聂卫群[1] WANG Long-mei;GAO Zhi-ling;YIN Shuo-miao;LI Wei;NIE Wei-qun(Department of Critical Care Medicine,The First Affiliated Hospital of Anhui University of Traditional Chinese medicine,Hefei,Anhui,230031,China)

机构地区：[1]安徽中医药大学第一附属医院重症医学科,安徽合肥230031

出　　处：《现代生物医学进展》2022年第19期3776-3779,共4页Progress in Modern Biomedicine

基　　金：安徽省高等学校省级质量工程项目(2019jyxm1025);安徽中医药大学科研基金项目(2021yfylc12)。

摘　　要：目的:研究头孢哌酮/舒巴坦联合替加环素治疗耐碳青霉烯类鲍曼不动杆菌感染的临床疗效及对患者急性生理与慢性健康评分(APACHE Ⅱ)评分及血清C-反应蛋白(CRP)、降钙素原(PCT)水平的影响,为预防和控制耐碳青霉烯类鲍曼不动杆菌感染提供依据。方法:选取2018年12月至2021年12月收集的80例耐碳青霉烯类鲍曼不动杆菌感染的患者为研究对象,所有受试者按抛掷硬币法随机分为观察组(40例)和对照组(40例)。对照组给予头孢哌酮/舒巴坦治疗,观察组给予头孢哌酮/舒巴坦联合替加环素治疗。治疗7 d后,比较两组治疗总有效率、细菌总清除率;比较治疗前后APACHE Ⅱ评分及CRP、PCT水平的变化。结果:治疗7d后,观察组总有效率为72.50%(29/40),明显高于对照组的40.00%(16/40),差异有统计学意义(P<0.05)。治疗7d后,观察组细菌总清除率为67.50%(27/40),高于对照组的30.00%(12/40),差异有统计学意义(P<0.05)。治疗前两组APACHE Ⅱ评分及CRP、PCT水平比较,差异均无统计学意义(P>0.05);治疗7d后,两组APACHE Ⅱ评分及CRP、PCT水平均有所下降,且观察组明显低于对照组,组间比较差异有统计学意义(P<0.05)。结论:头孢哌酮/舒巴坦联合替加环素治疗耐碳青霉烯类鲍曼不动杆菌感染的临床效果显著,有利于缓解患者的炎症反应,改善其临床症状及控制感染,值得临床推广应用。Objective:To study the clinical efficacy of cefoperazone/sulbactam combined with tegacyclin in the treatment of carbapenem resistant acinetobacter baumannii infection and its effect on the acute physiology and chronic health(APACHE Ⅱ) score and the levels of serum C-reactive protein(CRP) and procalcitonin(PCT),so as to provide basis for the prevention and control of carbapenem resistant acinetobacter baumannii infection.Methods:80 patients with carbapenem resistant acinetobacter baumannii infection collected from December 2018 to December 2021 were selected as the research objects.All subjects were randomly divided into observation group(40 cases) and control group(40 cases) by coin tossing method.The control group was treated with cefoperazone/sulbactam,and the observation group was treated with cefoperazone/sulbactam combined with tegacyclin.After 7 days of treatment,the total effective rate and total bacterial clearance rate of the two groups were compared.The changes of APACHE Ⅱ score,CRP and PCT levels before and after treatment were compared.Results:After 7 days of treatment,the total effective rate of the observation group was 72.50%(29/40),which was significantly higher than that of the control group 40.00%(16/40),and the difference was statistically significant(P<0.05).After 7 days of treatment,the total bacterial clearance rate in the observation group was 67.50%(27/40),higher than 30.00%(12/40) in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in APACHE Ⅱ score,CRP and PCT levels between the two groups before treatment(P>0.05);After 7 days of treatment,APACHE Ⅱ score,CRP and PCT levels in the two groups decreased,and the observation group was significantly lower than that in the control group.The difference between the two groups was statistically significant(P<0.05).Conclusion:The clinical effect of cefoperazone/sulbactam combined with tegacyclin in the treatment of carbapenem resistant acinetobacter baumannii infection is signifi

关 键 词：头孢哌酮/舒巴坦 替加环素 耐碳青霉烯 鲍曼不动杆菌 APACHEⅡ评分 炎性因子 

分 类 号：R378.91[医药卫生—病原生物学]