卡泊芬净联合美罗培南在肾移植术后肺感染患者中的应用效果观察  

Efficacy of carpofungin combined with meropenem in patients with lung infection after kidney transplantation

作　　者：孙东 王红宇 王凯[1] 王振璞 乔良伟 Sun Dong;Wang Hong-yu;Wang Kai;Wang Zhen-pu;Qiao Liang-wei(Department of Kidney Transplantation,The People’s Hospital of Zhengzhou,Zhengzhou 450003,China)

机构地区：[1]河南中医药大学第五临床医学院(郑州人民医院)肾移植科,河南郑州450003

出　　处：《四川生理科学杂志》2024年第5期979-981,1055,共4页Sichuan Journal of Physiological Sciences

基　　金：河南省高等学校重点科研项目(23A320025)。

摘　　要：目的:分析肾移植术后肺感染治疗中卡泊芬净联合美罗培南的应用效果及对患者肺功能、炎症因子的影响。方法:选定我院肾移植科2021年1月至2023年1月就诊的120例肾移植术后肺感染患者,根据治疗方法的不同将其分为两组,各60例,传统组给予醋酸泼尼松等对症治疗,观察组在传统组基础上给予卡泊芬净联合美罗培南治疗,两组均在治疗14d后进行效果评价,通过χ^(2)检验、t检验比较两组临床疗效、病原菌分布、血清炎症因子、不良反应总发生率。结果:观察组临床总有效率(96.67%)高于传统组(76.67%),P<0.05。观察组治疗后铜绿假单胞菌(5.00%)、肺炎克雷伯菌(3.33%)、鲍氏不动杆菌(5.00%)、白色假丝酵母菌(3.33%)构成比均低于传统组(16.67%、13.33%、18.33%、15.00%),P<0.05。观察组治疗后血清肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)、降钙素原(Procalcitonin,PCT)、C反应蛋白(C-reactive protein,CRP)水平均低于传统组,P<0.05。观察组不良反应总发生率(5.00%)与传统组(8.33%)比较,P>0.05。结论:卡泊芬净联合美罗培南可有效改善肾移植术后肺感染患者临床症状,抑制病原菌生长、繁殖,减轻炎症反应,且未增加不良反应,具有一定的安全性。Objective:To analyze the application effect of carpofungine combined with meropenem in the treatment of lung infection after kidney transplantation and the intervention effect on lung function and inflammatory response of patients.Methods:A total of 120 patients with pulmonary infection after kidney transplantation were selected from the Department of Kidney Transplantation of our hospital from January 2021 to January 2023,and divided into two groups with 60 cases each according to different treatment methods.The traditional group was given symptomatic treatment such as prednisone acetate,while the observation group was given carpofungine combined with meropenem on the basis of the traditional group.The efficacy of both groups was evaluated after 14 days of treatment.Chi-square test and T-test were used to compare the clinical efficacy,pathogenic bacteria distribution,serum inflammatory factors and the total incidence of adverse reactions between the two groups.Results:The total clinical effective rate of observation group(96.67%)was higher than that of traditional group(76.67%),P<0.05.After treatment,forced vital capacity(FVC),forced expiratory volume in the first second(FEV1)and FEV1/FVC in the observation group were higher than those in the traditional group,P<0.05.After treatment,the serum levels of tumor necrosis factor-α(TNF-α),procalcitonin(PCT)and C-reactive protein(CRP)in observation group were lower than those in traditional group,P<0.05.The total incidence of adverse reactions in observation group(5.00%)was compared with that in traditional group(8.33%),P>0.05.Conclusion:Carpofungin combined with meropenem can effectively improve lung function and clinical symptoms in patients with lung infection after kidney transplantation,reduce inflammatory reactions,and do not increase adverse reactions,so it has a certain safety.

关 键 词：肾移植 肺部感染 卡泊芬净 美罗培南 肺功能 炎症因子 

分 类 号：R699.2[医药卫生—泌尿科学]