机构地区:[1]天津市第五中心医院呼吸与危重症医学科,天津300450
出 处:《现代药物与临床》2022年第12期2795-2799,共5页Drugs & Clinic
基 金:国家自然科学基金项目(81900407)。
摘 要:目的 探讨喜炎平注射液联合比阿培南治疗重症肺炎的临床效果。方法 选取2019年3月—2022年3月天津市第五中心医院收治的118例重症肺炎患者,按随机数字表法将所有患者分成对照组和治疗组,每组各59例。对照组静脉滴注注射用比阿培南,每次将0.3 g溶于100 mL生理盐水中,滴注30~60 min,2次/d。治疗组在对照组基础上静脉滴注喜炎平注射液,每次将500 mg加入250 mL生理盐水中,1次/d。两组连续治疗14 d。观察两组的临床疗效和典型表现(发热、咳嗽、胸闷痛、肺部啰音、白细胞异常)消失时间。比较治疗前后两组临床肺部感染评分(CPIS)、急性生理功能和慢性健康状况评分系统Ⅱ(APACHEⅡ)评分及血清C反应蛋白(CRP)、降钙素原(PCT)、可溶性细胞间黏附分子-1(sICAM-1)、白细胞介素(IL)-17、基质金属蛋白酶-9(MMP-9)水平。结果 治疗后,治疗组总有效率为93.2%,显著高于对照组的81.4%(P<0.05)。治疗后,治疗组发热、咳嗽、胸闷痛、肺部啰音、白细胞异常的消失时间均较对照组显著缩短(P<0.05)。治疗后,两组CPIS评分和APACHEⅡ评分均较治疗前显著降低(P<0.05);且均以治疗组下降更显著(P<0.05)。治疗后,两组血清CRP、PCT、sICAM-1、IL-17、MMP-9水平均较治疗前显著下降(P<0.05);且均以治疗组降低更显著(P<0.05)。结论 喜炎平注射液联合比阿培南治疗重症肺炎的总体疗效满意,能迅速缓解患者症状及体征,减轻肺部感染及全身炎症反应,改善组织器官损伤,促进病情恢复,且安全性较好。Objective To investigate the clinical effect of Xiyanping Injection combined with biapenem in treatment of severe pneumonia. Methods A total of 118 patients with severe pneumonia admitted to Tianjin Fifth Central Hospital from March 2019 to March 2022 were selected and divided into control group and treatment group according to the random number table method, with 59cases in each group. Patients in the control group were iv administered with Biapenem for injection, 0.3 g was dissolved in 100 mL normal saline and injected for 30—60 min, twice daily. Patients in the treatment group were iv administered with Xiyanping Injection on the basis of the control group, 500 mg was added to 250 mL normal saline once daily. The two groups were treated for 14 d. The clinical efficacy and disappearance time of typical manifestations(fever, cough, chest tightness and pain, lung rales, abnormal white blood cells) of the two groups were observed. The clinical pulmonary infection score(CPIS), acute physiological function and chronic health evaluation System Ⅱ(APACHEⅡ) score, serum C-reactive protein(CRP), procalcitonin(PCT), soluble intercellular adhesion molecular 1(sICAM-1), interleukin(IL)-17, and matrix metalloproteinase-9(MMP-9) were compared between the two groups before and after treatment level. Results After treatment, the total effective rate of the treatment group was 93.2%, which was significantly higher than that of the control group(81.4%, P < 0.05). After treatment, the disappearance time of fever, cough, chest tightness and pain, lung rales and white blood cell abnormalities in the treatment group were significantly shorter than those in the control group(P < 0.05). After treatment, the CPIS score and APACHEⅡ score of the two groups were significantly lower than those before treatment(P < 0.05). The decrease was more significant in the treatment group(P < 0.05). After treatment, the serum levels of CRP, PCT, sICAM-1,IL-17 and MMP-9 in the two groups were significantly decreased compared with those before tre
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