两种抗感染药物治疗重症肺炎的效果及炎症因子水平预后比较  

Comparison of the Effects of Two Anti-Infective Drugs on Severe Pneumonia,Inflammatory Factor Levels,and Prognosis

作　　者：王亮亮 王凯 曹继飞 尉玉杰[1] WANG Liangliang(Wanbei Coal and Electric Group General Hospital,Anhui Su Zhou 234000,China)

机构地区：[1]皖北煤电集团总医院重症医学二科,安徽宿州234000 [2]蚌埠医学院第一附属医院肿瘤科,安徽蚌埠233000

出　　处：《河北医学》2024年第1期153-157,共5页Hebei Medicine

基　　金：安徽省2021年度高校科学研究项目,(编号:KJ2021A0729)。

摘　　要：目的:探究哌拉西林钠他唑巴坦与亚胺培南西司他丁钠治疗重症肺炎的效果及对炎症因子水平、预后的影响。方法:选取2020年1月至2023年3月我院收治的105例重症肺炎患者,用随机数字表法分为A组(n=53)和B组(n=52),A组用亚胺培南西司他丁钠治疗,B组用哌拉西林钠他唑巴坦钠治疗。比较两组患者临床症状消失时间(咳嗽、肺阴影、肺啰音、体温恢复时间),比较治疗前和治疗7d后,两组患者严重程度[肺部感染量表(CPIS)、急性生理学及慢性健康状况(APACHEⅡ)、Murray肺损伤量表(MLIS)]、血气指标[氧饱和度(SpO_(2))、血氧分压(PaO_(2))、二氧化碳分压(PaCO_(2))]及炎症因子[白细胞总数(WBC)、C-反应蛋白(CRP)、降钙素原(PCT)]水平,统计不良反应发生情况。结果:B组咳嗽、肺阴影、肺啰音消失时间及体温恢复时间均短于A组(P均<0.05);治疗7d后,两组患者CPIS、APACHEⅡ、MLIS评分、PaCO_(2)、炎症因子(WBC、CRP、PCT)水平均显著降低,B组水平变化大于A组(P均<0.05);部分血气指标(SpO_(2)、PaO_(2))水平显著升高,B组水平变化大于A组(P均<0.05);两组患者不良反应发生率无显著性差异(P>0.05)。结论:哌拉西林钠他唑巴坦钠与亚胺培南西司他丁钠均可减轻重症肺炎患者病情及临床症状,改善血气状况,缓解炎症反应,但哌拉西林钠他唑巴坦钠效果更佳。Objective:To explore the effectiveness of piperacillin tazobactam and imipenem cilastatin sodium in the treatment of severe pneumonia and their impact on inflammatory factor levels and prognosis.Methods:A total of 105 patients with severe pneumonia admitted to our hospital from January 2020 to March 2023 were selected.Using a random number table,they were divided into Group A(n=53)treated with imipenem cilastatin sodium and Group B(n=52)treated with piperacillin tazobactam sodium.Clinical symptom disappearance times(cough,pulmonary shadow,pulmonary rales,temperature recovery time)were compared between the two groups.The severity[Clinical Pulmonary Infection Score(CPIS),Acute Physiology and Chronic Health EvaluationⅡ(APACHEⅡ),Murray Lung Injury Score(MLIS)],blood gas parameters[oxygen saturation(SpO_(2)),partial pressure of oxygen(PaO_(2)),partial pressure of carbon dioxide(PaCO_(2))],and levels of inflammatory factors[white blood cell count(WBC),C-reactive protein(CRP),procalcitonin(PCT)]were compared before and after 7 days of treatment.Adverse reactions were recorded.Results:Group B had shorter times for cough,disappearance of pulmonary shadow,pulmonary rales,and temperature recovery than Group A(P<0.05).After 7 days of treatment,both groups showed significant reductions in CPIS,APACHEⅡ,MLIS scores,PaCO_(2),and inflammatory factors(WBC,CRP,PCT),with larger reductions in Group B(P<0.05).Some blood gas parameters(SpO_(2),PaO_(2))significantly increased,with greater changes in Group B(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Piperacillin tazobactam sodium and imipenem cilastatin sodium can alleviate the condition and clinical symptoms of patients with severe pneumonia,improve blood gas conditions,and relieve inflammatory reactions.However,piperacillin tazobactam sodium shows bet-ter efficacy.

关 键 词：重症肺炎 哌拉西林钠他唑巴坦 亚胺培南西司他丁钠 炎症因子 血气指标 

分 类 号：R563.1[医药卫生—呼吸系统]