替加环素联合多巴酚丁胺治疗重症肺炎的疗效及对肺功能、免疫功能的影响  

Efficacy of Tigecycline Combined with Dobutamine in the Treatment of Severe Pneumonia and Its Effects on Pulmonary Function and Immune Function

作　　者：魏晓颖 王蕊 史玉洁 李霞 张鸿儒 WEI Xiaoying;WANG Rui;SHI Yujie;LI Xia;ZHANG Hongru(Dept.of Inpatient,Zhangjiakou First Hospital,Hebei Zhangjiakou 075000,China;Dept.of Respiratory Medicine,Renqiu People’s Hospital,Hebei Cangzhou 062550,China;Dept.of Traditional Chinese Medicine,Zhangjiakou First Hospital,Hebei Zhangjiakou 075000,China;Dept.of Respiratory Medicine,Zhangjiakou First Hospital,Hebei Zhangjiakou 075000,China;Dept.of Pharmacy,Zhangjiakou First Hospital,Hebei Zhangjiakou 075000,China)

机构地区：[1]张家口市第一医院住院部,河北张家口075000 [2]任丘市人民医院呼吸内科,河北沧州062550 [3]张家口市第一医院中医科,河北张家口075000 [4]张家口市第一医院呼吸内科,河北张家口075000 [5]张家口市第一医院药剂科,河北张家口075000

出　　处：《中国医院用药评价与分析》2025年第4期434-437,441,共5页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：河北省医学科学研究课题计划(No.20241320)。

摘　　要：目的:探讨替加环素联合多巴酚丁胺治疗重症肺炎的疗效及对肺功能、免疫功能的影响。方法:选取2021年10月至2023年10月张家口市第一医院收治的重症肺炎患者112例,按不同的治疗方式分为替加环素组和多巴酚组,每组56例。替加环素组患者仅采用替加环素治疗,多巴酚组患者在替加环素组的基础上加用多巴酚丁胺治疗,治疗周期20 d。记录并比较治疗前后的免疫功能指标水平、临床治疗效果、炎症因子、肺功能指标及药品不良反应发生情况。结果:治疗后,多巴酚组患者的总有效率较替加环素组显著升高(94.64%vs.76.79%),差异有统计学意义(χ^(2)=7.292,P<0.05)。治疗后,两组患者降钙素原、C反应蛋白、白细胞计数、中心静脉压、左心室舒张末期容积及CD8^(+)水平较同组治疗前显著降低,每搏输出量、平均动脉压、CD4^(+)、CD3^(+)及CD4^(+)/CD8^(+)水平较同组治疗前显著升高,且多巴酚组患者明显优于替加环素组,差异均有统计学意义(P<0.05)。治疗期间,多巴酚组患者的不良反应发生率显著低于替加环素组(8.93%vs.25.00%),差异有统计学意义(χ^(2)=3.998,P<0.05)。结论:与单一替加环素治疗相比,替加环素联合多巴酚丁胺治疗重症肺炎能更有效地增强患者肺功能,提高免疫功能,提高疗效。OBJECTIVE:To probe into the efficacy of tigecycline combined with dobutamine in the treatment of severe pneumonia and its effects on pulmonary function and immune function.METHODS:A total of 112 patients with severe pneumonia admitted into Zhangjiakou First Hospital from Oct.2021 to Oct.2023 were extracted to be divided into tigacycline group and dobutamine group according to different treatment methods,with 56 cases in each group.The tigacycline group was given tigecycline alone,while the dobutamine group received dobutamine based on the tigacycline group,both groups were treated for 20 d.The levels of immune function indicators,the clinical treatment effects,incidences adverse drug reactions,inflammatory factors,and pulmonary function indicators before and after treatment were recorded and compared between two groups.RESULTS:The total effective rate of the dobutamine group was significantly higher than that of the tigacycline group(94.64%vs.76.79%),with statistically significant difference(χ^(2)=7.292,P<0.05).After treatment,the procalcitonin,C-reactive protein,white blood cell count,central venous pressure,left ventricular end-diastolic volume and CD8^(+)in both groups were significantly lower than those before treatment,the stroke volume,mean arterial pressure,CD4^(+),CD3^(+)and CD4^(+)/CD8^(+)were significantly higher than those before treatment,and all the above indicators were significantly better in the dobutamine group than those in the tigacycline group,with statistically significant differences(P<0.05).During treatment,the incidence of adverse drug reactions of the dobutamine group was significantly lower than that of the tigacycline group(8.93%vs.25.00%),with statistically significant difference(χ^(2)=3.998,P<0.05).CONCLUSIONS:Compared with tigecycline alone,the combination of tigecycline and dobutamine in the treatment of severe pneumonia can effectively enhance patients’pulmonary function,promote immune function and efficacy.

关 键 词：重症肺炎 多巴酚丁胺 替加环素 免疫功能 

分 类 号：R978.1[医药卫生—药品] R972.1[医药卫生—药学]