哌拉西林/他唑巴坦联合莫西沙星治疗肝硬化腹水合并腹腔感染的疗效  

Efficacy of piperacillin-tazobactam combined with moxifloxacin in the treatment of cirrhotic ascites complicated with peritoneal infection

作　　者：易书林 童南南 李勇 董冀南 张芝华 冯玉明 YI Shu-lin;TONG Nan-nan;LI Yong;DONG Ji-nan;ZHANG Zhi-hua;FENG Yu-ming(Yingtan People's Hospital,Yingtan,Jiangri 335200,China)

机构地区：[1]鹰潭市人民医院感染科,江西鹰潭335200 [2]鹰潭市人民医院药剂科,江西鹰潭335200 [3]鹰潭市人民医院消化科,江西鹰潭335200 [4]鹰潭市人民医院全科医学科,江西鹰潭335200

出　　处：《中华医院感染学杂志》2024年第23期3571-3575,共5页Chinese Journal of Nosocomiology

基　　金：江西省中医药管理局科技计划基金资助项目(2021A0372)。

摘　　要：目的探究哌拉西林/他唑巴坦联合莫西沙星治疗肝硬化腹水合并腹腔感染的疗效及其中性粒细胞载脂蛋白(HNL)、胃饥饿素(Ghrelin)、单核细胞与淋巴细胞比值(MLR)水平。方法选取鹰潭市人民医院2020年6月—2023年6月收治的100例肝硬化腹水合并腹腔感染的患者,根据治疗方法分为联合组(n=62)和对照组(n=38);对照组采用莫西沙星治疗方案,联合组在对照组的基础上增加哌拉西林/他唑巴坦治疗;比较两组疗效、治疗前后的肝功能指标[丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、碱性磷酸酶(ALP)]、免疫功能指标[外周血淋巴细胞CD_(3)^(+)、CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)]和血清HNL、Ghrelin、MLR水平,并记录不良反应事件情况。结果联合组疗效优于对照组(P=0.031);治疗后,两组血清肝功能指标水平均低于治疗前,且联合组ALT、AST和ALP分别为135.73±30.62、42.07±9.30和(31.69±8.75)U/L,低于对照组(P<0.05);治疗后,两组的免疫功能指标水平均高于治疗前,且联合组CD_(3)^(+)、CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)分别为(53.29±5.78)%、(44.07±3.52)%和1.80±0.45,高于对照组(P<0.05);治疗后两组血清HNL、Ghrelin、MLR水平均低于治疗前,且联合组HNL、Ghrelin、MLR分别为(109.99±30.14)ng/ml、(205.80±36.67)ng/L和0.30±0.08低于对照组(P<0.05)。结论哌拉西林/他唑巴坦联合莫西沙星对于肝硬化腹水合并腹腔感染患者的治疗具有较高的疗效,可有效改善患者的肝功能、免疫功能及血清HNL、Ghrelin、MLR水平。OBJECTIVE To explore the therapeutic effect of piperacillin/tazobactam combined with moxifloxacin in the treatment of cirrhotic ascites complicated with abdominal infection,and serum neutrophil apolipoprotein(HNL),Ghrelin,and monocyte to lymphocyte ratio(MLR)levels.METHODS A total of 1oO patients with cirrhosis ascites combined with abdominal infection admitted to Yingtan People's Hospital from Jun.2020 to Jun.2023 were selected and divided into a combination group(n=62)and a control group(n=38)according to treatment methods.The control group was treated with moxifloxacin,and the combination group was treated with piperacillin and tazobactam on the basis of control group.The effectiveness,liver function indexes [alanine aminotransferase(ALT),aspartate aminotransferase(AST),alkaline phosphatase(ALP)],immune function indexes [peripheral blood lymphocytes CD_(3)^(+),CD_(4)^(+),CD_(4)^(+)/CD_(8)^(+)] and serum HNL,Ghrelin,MLR levels before and after treatment were compared between the two groups.The occurrence of adverse events was recorded.RESULTS The effectiveness of the combination group was better than that of the control group(P=0.031);After treatment,the serum liver function indicators in both groups were lower than before treatment,and the ALT,AST,and ALP levels in the combination group were 135.73±30.62,42.07±9.30,and(31.69±8.75)U/L,respectively,which were lower than those in the control group(P<0.05);After treatment,the levels of immune function indicators in both groups were higher than before treatment,and the CD_(3)^(+),CD_(4)^(+),CD_(4)^(+)/CD_(8)^(+)in the combination group were(53.29±5.78)%,(44.07±3.52)%,and 1.80±0.45,respectively,which were higher than those in the control group(P<0.05);After treatment,the serum levels of HNL,Ghrelin,and MLR in both groups were lower than before treatment,and the HNL,Ghrelin,and MLR in the combination group were(109.99±30.14)ng/L,(205.80±36.67)ng/L,and 0.30±0.08,respectively,which werelower than those in the control group(P<0.05).CONCLUSION Piperacillin-tazob

关 键 词：哌拉西林/他唑巴坦 莫西沙星 肝硬化腹水 腹腔感染 中性粒细胞载脂蛋白 胃饥饿素 单核细胞与淋巴细胞比值 

分 类 号：R657.31[医药卫生—外科学]