血必净注射液联合莫西沙星序贯给药治疗老年重症社区获得性肺炎的效果及对外周血T淋巴细胞亚群和TNF-α、IL-6水平的影响  

Efficacy of Xuebijing Injection Combined with Moxifloxacin Sequential Administration in the Treatment of Elderly Patients with Severe Community-acquired Pneumonia and Its Influence on Peripheral Blood T Lymphocyte Subsets, TNF-α and IL-6 Levels

作　　者：喻承伟 何芳志 贺燕 温桂兰[2] YU Chengwei;HE Fangzhi;HE Yan;WEN Guilan(The Second People’s Hospital of Pingxiang City,Jiangxi Province,Pingxiang 337000,China;不详)

机构地区：[1]江西省萍乡市第二人民医院,江西萍乡337000 [2]南昌大学第一附属医院

出　　处：《中国医学创新》2022年第35期134-139,共6页Medical Innovation of China

摘　　要：目的:探讨血必净注射液联合莫西沙星序贯给药治疗老年重症社区获得性肺炎(SCAP)的临床效果及对外周血T淋巴细胞亚群和肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)水平的影响。方法:选取2019年9月-2020年8月萍乡市第二人民医院收治的158例老年SCAP患者,采用随机数字表法将其分为观察组(n=79)与对照组(n=79)。对照组采取莫西沙星序贯给药治疗,观察组则在对照组的基础上联合血必净注射液治疗,疗程均为2周。比较两组临床疗效及用药安全性。比较两组机械通气时间、重症监护室(ICU)住院时间、28 d病死率、肺炎严重程度指数(PSI)评分、外周血T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+))水平和血清TNF-α、IL-6水平。结果:观察组总有效率为92.4%(73/79),较对照组的81.0%(64/79)提高(P<0.05)。两组治疗后PSI评分均较治疗前下降,且观察组低于对照组(P<0.05)。与对照组相比,观察组机械通气时间、ICU住院时间均缩短(P<0.05)。观察组28 d病死率为8.9%(7/79),低于对照组的16.5%(13/79),但差异无统计学意义(P>0.05)。两组治疗后外周血CD3^(+)、CD4^(+)水平及CD4^(+)/CD8^(+)均高于治疗前,且观察组均高于对照组(P<0.05)。与治疗前相比,两组治疗后血清TNF-α和IL-6水平均显著降低,且观察组均低于对照组(P<0.05)。观察组不良反应发生率为6.3%(5/79),与对照组的5.1%(4/79)相比,差异无统计学意义(P>0.05)。结论:血必净注射液联合莫西沙星序贯给药治疗老年SCAP的整体效果确切,能安全有效地缓解患者病情,改善预后,其作用可能与下调血清TNF-α、IL-6的表达水平及纠正外周血T淋巴细胞亚群平衡有关。Objective: To investigate the clinical efficacy of Xubijing Injection combined with Moxifloxacin sequential administration in the treatment of elderly patients with severe community-acquired pneumonia(SCAP)and the its influence on peripheral blood T lymphocyte subsets, TNF-αand IL-6 levels. Method: A total of 158elderly patients with SCAP admitted to the Second People’s Hospital of Pingxiang City from September 2019 to August 2020 were selected, they were divided into observation group(n=79) and control group(n=79) by random number table method. The control group was treated with Moxifloxacin sequential administration, and the observation group was treated with Xuebijing Injection on the basis of the control group, the course of treatment was 2 weeks.The clinical efficacy and drug safety of the two groups were compared. The duration of mechanical ventilation,length of stay in Intensive Care Unit(ICU), 28 d mortality rate, pneumonia severity index(PSI) scores, peripheral blood T lymphocyte subsets(CD3, CD4, CD4/CD8) and serum TNF-α and IL-6 levels were compared between the two group. Result: The total effective rate of the observation group was 92.4%(73/79), which was higher than 81.0%(64/79) of the control group(P<0.05). PSI scores of both groups after treatment were lower than those before treatment, and that of the observation group was lower than that of the control group(P<0.05). Compared with the control group, the duration of mechanical ventilation, length of stay in ICU of the observation group were shortened(P<0.05). The 28 d mortality rate of the observation group was 8.9%(7/79), which was lower than 16.5%(13/79)of the control group, the difference was not statistically significant(P>0.05). After treatment, the levels of CD3,CD4and CD4/CD8in peripheral blood of both groups were higher than those before treatment, and those of the observation group were higher than those of the control group(P<0.05). Compared with before treatment, serum TNF-α and IL-6 levels of both groups were decreased after treat

关 键 词：血必净注射液 莫西沙星 重症社区获得性肺炎 T淋巴细胞亚群 肿瘤坏死因子-α 

分 类 号：R563.1[医药卫生—呼吸系统]