盐酸氨溴索联合莫西沙星、比阿培南治疗老年重症肺炎对患者肺泡灌洗液TLR4、PCT、hs-CRP水平的影响  

Effects of Ambroxol Hydrochloride Combined with Moxifloxacin and Biapenem in the Treatment of Elderly Patients with Severe Pneumonia on Levels of TLR4,PCT and hs-CRP in Alveolar Lavage Fluid

作　　者：姚贇 徐丽晶 罗彬 苏伟 孙攀博 YAO Yun;XU Lijing;LUO Bin;SU Wei;SUN Panbo(Department of Respiratory and Critical Care Medicine,Shangrao Municipal Hospital,Shangrao 334000,China;不详)

机构地区：[1]上饶市立医院呼吸与危重症医学科,江西上饶334000

出　　处：《中国医学创新》2024年第26期136-140,共5页Medical Innovation of China

基　　金：江西省卫生健康委科技计划项目(202410979)。

摘　　要：目的:探讨盐酸氨溴索联合莫西沙星、比阿培南治疗老年重症肺炎(SP)的效果及对患者肺泡灌洗液中Toll样受体4(TLR4)、降钙素原(PCT)、超敏C反应蛋白(hs-CRP)水平的影响。方法:选取2023年1—12月在上饶市立医院接受治疗的80例老年SP患者,以随机数字表法分成对照组与观察组,各40例。两组均接受支气管肺泡灌洗治疗,对照组予以莫西沙星、比阿培南治疗,观察组在对照组基础上接受盐酸氨溴索治疗,两组均接受为期10 d的治疗。分析两组临床疗效、临床症状、血气指标及炎症因子,并记录不良反应发生率。结果:观察组临床总有效率高于对照组,咳嗽减轻时间、咳痰减轻时间、体温恢复正常时间均早于对照组,治疗后血乳酸、动脉血二氧化碳分压(PaCO_(2))、TLR4、PCT、hs-CRP水平均低于对照组,经皮动脉血氧饱和度(SpO_(2))、动脉血氧分压(PaO_(2))、氧合指数均高于对照组(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:盐酸氨溴索联合莫西沙星、比阿培南治疗老年SP的效果较好,可降低肺泡灌洗液中炎症因子水平,改善血乳酸及动脉血气指标。Objective:To investigate the effect of Ambroxol Hydrochloride combined with Moxifloxacin and Biapenem in the treatment of severe pneumonia(SP)in the elderly and its influence on the levels of Toll-like receptor 4(TLR4),procalcitonin(PCT)and high sensitivity C reactive protein(hs-CRP)in alveolar lavage fluid of patients.Method:A total of 80 elderly patients with SP treated in Shangrao Municipal Hospital from January to December 2023 were selected and divided into control group and observation group by random number table method,with 40 cases in each group.Both groups were treated with bronchoalveolar lavage,the control group was treated with Moxifloxacin and Biapenem,the observation group was treated with Ambroxol Hydrochloride on the basis of the control group,and both groups were treated for 10 days.The therapeutic effect,clinical symptoms,blood gas indexes and inflammatory factors of the two groups were analyzed,and the incidence of adverse reactions were recorded.Result:The total clinical effective rate of the observation group was higher than that of the control group,the time to relieve cough,the time to relieve sputum and the time of body temperature return to normal were earlier than those of the control group,after treatment,the levels of blood lactic acid,arterial partial pressure of carbon dioxide(PaCO_(2)),TLR4,PCT and hs-CRP were lower than those of the control group,and percutaneous arterial oxygen saturation(SpO_(2)),partial pressure of oxygen in arterial blood(PaO_(2))and oxygenation index were higher than those of control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Ambroxol Hydrochloride combined with Moxifloxacin and Biapenem have a better effect in the treatment of elderly SP,which can reduce the levels of inflammatory factors in alveolar lavage fluid and improve blood lactic acid and arterial blood gas indexes.

关 键 词：盐酸氨溴索 莫西沙星 比阿培南 老年重症肺炎 肺泡灌洗液 血乳酸 

分 类 号：R563.1[医药卫生—呼吸系统]