头孢哌酮舒巴坦治疗脑卒中并发肺炎临床观察  

Clinical Observation of Cefoperazone-Sulbactam in the Treatment of Stroke Complicated with Pneumonia

作　　者：张华[1] 郭情情 苏奕亮 翁东[4] ZHANG Hua;GUO Qingqing;SU Yiliang;WENG Dong(East Hospital of Zibo Central Hospital,Zibo,Shandong,China 255000;Peking University Care Luzhong Hospital,Zibo,Shandong,China 255400;Shanghai Tongren Hospital,Shanghai,China 200050;Shanghai Pulmonary Hospital,Shanghai,China 200433)

机构地区：[1]山东省淄博市中心医院东院,山东淄博255000 [2]北大医疗鲁中医院,山东淄博255400 [3]上海同仁医院,上海200050 [4]上海市肺科医院,上海200433

出　　处：《中国药业》2025年第3期93-96,共4页China Pharmaceuticals

基　　金：上海市科技计划项目[22ZR1452300]。

摘　　要：目的探讨头孢哌酮舒巴坦治疗脑卒中并发肺炎的临床疗效,以及对患者氧化应激指标、氨基末端脑利钠肽前体(NT-proBNP)及Toll样受体(TLR)水平的影响。方法回顾性分析山东省淄博市中心医院东院2021年3月至2023年3月收治的106例脑卒中并发肺炎患者的临床资料,按治疗方案的不同分为常规组(47例)和干预组(59例)。两组患者均予常规营养神经、抗感染治疗,在此基础上,常规组患者加用头孢他啶,干预组患者加用头孢哌酮舒巴坦,两组患者均连续治疗2周。结果干预组总有效率为89.83%,显著高于常规组的68.09%(P<0.05)。治疗后,干预组患者的细菌清除率为86.44%,显著高于对照组的68.09%(P<0.05);两组患者的丙二醛、降钙素原、白细胞介素6、脂质过氧化氢、C反应蛋白、TLR、NT-proBNP水平均显著降低(P<0.05),超氧化物歧化酶水平均显著升高(P<0.05),且干预组均显著优于常规组(P<0.05)。干预组和常规组患者不良反应发生率相当(6.78%比6.38%,P>0.05)。结论头孢哌酮舒巴坦治疗脑卒中并发肺炎的临床疗效良好,可有效降低患者的TLR和NT-proBNP水平,减轻炎性反应和氧化应激反应,且安全性良好。Objective To investigate the clinical efficacy of cefoperazone-sulbactam in the treatment of stroke complicated with pneumonia,and its effect on oxidative stress indicators,N-terminal pro-brain natriuretic peptide(NT-proBNP),and toll-like receptor(TLR)levels in patients.Methods A retrospective analysis was conducted on the clinical data of 106 patients with stroke complicated with pneumonia admitted to the East Hospital of Zibo Central Hospital from March 2021 to March 2023.The patients were divided into the routine group(47 cases)and the intervention group(59 cases)according to different treatment plans.The patients in the two groups were given routine nutritional nerve and anti-infective treatment,on this basis,the patients in the routine group were additionally given ceftazidime,while the patients in the intervention group were additionally given cefoperazone-sulbactam.Both groups were continuously treated for two weeks.Results The total effective rate in the intervention group was 89.83%,which was significantly higher than 68.09% in the routine group(P<0.05).After treatment,the bacterial clearance rate in the routine group was 86.44%,which was significantly higher than 68.09% in the routine group(P<0.05);the levels of malondialdehyde(MDA),procalcitonin(PCT),interleukin-6(IL-6),lipid hydroperoxide(LHP),C-reactive protein(CRP),TLR,and NT-proBNP in the two groups significantly decreased(P<0.05),while the superoxide dismutase(SOD)levels in the two groups significantly increased(P<0.05),and those in the intervention group were significantly better than those in the routine group(P<0.05).The incidence of adverse reactions in the intervention group and the routine group was comparable(6.78%vs.6.38%,P>0.05).Conclusion Cefoperazone-sulbactam has good efficacy and safety in the treatment of stroke complicated with pneumonia,which can effectively reduce TLR and NT-proBNP levels,and alleviate inflammatory and oxidative stress reactions.

关 键 词：头孢哌酮舒巴坦 脑卒中并发肺炎 氧化应激反应 氨基末端脑利钠肽前体 TOLL样受体 

分 类 号：R969.4[医药卫生—药理学] R563.1[医药卫生—药学]