米诺环素联合头孢哌酮舒巴坦对MDR-AB感染重症肺炎患者肺功能及炎性因子的影响  

Effects of minocycline combined with cefoperazone sulbactam on lung function and inflammatory factors in patients with MDR-AB infection with severe pneumonia

作　　者：谢煊 郑重 汪华龙 XIE Xuan;ZHENG Zhong;WANG Hualong(Department of Clinical Pharmacy,Wuyishan Municipal Hospital,Fujian Province,Wuyishan 354300,China;不详)

机构地区：[1]武夷山市立医院临床药学室,福建省武夷山市354300 [2]武夷山市立医院重症医学科,福建省武夷山市354300 [3]武夷山市立医院呼吸与危重症医学科,福建省武夷山市354300

出　　处：《临床合理用药杂志》2024年第11期16-18,26,共4页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的 观察米诺环素联合头孢哌酮舒巴坦对多重耐药鲍曼不动杆菌(MDR-AB)感染重症肺炎患者肺功能及炎性因子的影响。方法 选取2020年1月—2023年6月武夷山市立医院收治的MDR-AB感染重症肺炎患者135例,根据随机数字表法分为联合组(68例)和对照组(67例)。在常规治疗基础上,对照组予头孢哌酮舒巴坦治疗,联合组在对照组基础上予米诺环素治疗,2组均治疗2周。比较2组疗效、细菌清除率,治疗前后肺功能[第1秒用力呼气容积(FEV_(1))、用力肺活量(FVC)、FEV_(1)/FVC]、炎性因子[白介素-8(IL-8)、C反应蛋白(CRP)、降钙素原(PCT)]及不良反应。结果 联合组总有效率为97.06%,高于对照组的86.57%(χ^(2)=4.964,P=0.026);联合组细菌总清除率为73.53%,高于对照组的56.72%(χ^(2)=4.204,P=0.040)。治疗2周后,2组FEV_(1)、FVC、FEV_(1)/FVC高于治疗前,且联合组高于对照组(P<0.05或P<0.01);2组IL-8、CRP、PCT水平低于治疗前,且联合组低于对照组(P<0.05或P<0.01)。联合组与对照组不良反应总发生率比较差异无统计学意义(14.71%vs.10.45%,χ^(2)=0.556,P=0.456)。结论 米诺环素联合头孢哌酮舒巴坦治疗MDR-AB感染重症肺炎疗效显著,可促进细菌清除,改善患者肺功能,减轻炎性反应,且安全性较高。Objective To observe the effect of minocycline combined with cefoperazone sulbactam on lung function and inflammatory factors in patients with severe pneumonia infected by multidrug-resistant acinetobacter baumannii(MDR-AB).Methods A total of 135 patients with MDR-AB infected severe pneumonia admitted to Wuyishan Municipal Hospital from January 2020 to June 2023 were selected and randomly divided into the combination group(68 cases) and the control group(67 cases).On the basis of conventional treatment,the control group was treated with cefoperazone sulbactam,and the combination group was treated with minocycline on the basis of the control group.Both groups were treated for 2 weeks.The curative effect,bacterial clearance rate,lung function(FEV_1,FVC,FEV_1/FVC) and inflammatory factors(IL-8,CRP,PCT) before and after treatment,as well as adverse reactions were compared between the two groups.Results The total effective rate of the combination group was 97.06%,which was higher than 86.57% of the control group(χ^(2)=4.964,P=0.026).The total bacterial clearance rate of the combined group was 73.53%,which was higher than 56.72% of the control group(χ^(2)=4.204,P=0.040).After 2 weeks of treatment,FEV_1,FVC,and FEV_1/FVC in the two groups were higher than those before treatment,and those in the combination group were higher than those in the control group(P<0.05 or P<0.01).The levels of IL-8,CRP and PCT in the two groups were lower than those before treatment,and those in the combined group were lower than those in the control group(P<0.05 or P<0.01).There was no significant difference in the total incidence of adverse reactions between the combination group and the control group(14.71% vs.10.45%,χ^(2)=0.556,P=0.456).Conclusion Minocycline combined with cefoperazone sulbactam in the treatment of MDR-AB infection with severe pneumonia has significant curative effect,can promote bacterial clearance,improve lung function,reduce inflammatory reaction,and have high safety.

关 键 词：多重耐药鲍曼不动杆菌 重症肺炎 米诺环素 头孢哌酮舒巴坦 肺功能 炎性因子 

分 类 号：R563.1[医药卫生—呼吸系统]