肺癌合并下呼吸道感染患者病原菌分布及美罗培南治疗效果分析  

Distribution of pathogenic bacteria in lung cancer patients complicated with lower respiratory tract infection and the effect of meropenem treatment

作　　者：张一凡 梁珍珍[1] 闫登峰[1] ZHANG Yifan;LIANG Zhenzhen;YAN Dengfeng(RICU,Zhoukou Central Hospital,Zhoukou 466000,He’nan,China)

机构地区：[1]周口市中心医院RICU,河南周口4660000

出　　处：《癌症进展》2025年第9期1054-1057,共4页Oncology Progress

摘　　要：目的探讨肺癌合并下呼吸道感染患者的病原菌分布情况和美罗培南治疗效果。方法将103例肺癌合并下呼吸道感染患者按照治疗方法的不同分为对照组(49例,使用亚胺培南西司他丁钠治疗)和研究组(54例,使用美罗培南治疗)。收集患者病原菌分布情况并进行耐药性检测,比较两组患者血气指标[动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、动脉血氧饱和度(SaO_(2)),计算氧合指数(OI)]、炎性因子[白细胞介素-6(IL-6)、降钙素原(PCT)和肿瘤坏死因子-α(TNF-α)]水平和症状改善情况。结果肺癌患者检出下呼吸道感染病原菌共103株,其中革兰阴性菌占比较高(62.05%),检出率前三位的细菌为铜绿假单胞菌(30.10%)、肺炎克雷伯菌(14.56%)和溶血葡萄球菌(11.65%)。铜绿假单胞菌和肺炎克雷伯菌对美罗培南的耐药率最低。治疗后,两组患者PaO_(2)、SaO_(2)、OI均高于治疗前,PaCO_(2)均低于治疗前,且研究组患者PaO_(2)、SaO_(2)、OI均高于对照组,PaCO_(2)低于对照组,差异均有统计学意义(P﹤0.05)。治疗后,两组患者TNF-α、PCT、IL-6水平均低于治疗前,且研究组患者TNF-α、PCT、IL-6水平均低于对照组,差异均有统计学意义(P﹤0.05)。研究组患者退热时间、咳嗽消失时间、肺部啰音消失时间、痰涂片转阴时间均明显短于对照组,差异均有统计学意义(P﹤0.01)。结论肺癌合并下呼吸道感染患者病原菌中革兰阴性菌较多,使用美罗培南进行治疗可有效改善患者血气指标,降低炎症因子水平,加快症状改善速度。Objective To explore the distribution of pathogenic bacteria in lung cancer(LC)patients complicated with lower respiratory tract infection(LRTI)and the effect of meropenem treatment.Method A total of 103 patients with LC complicated with LRTI were divided into control group(treated with imipenem and cilastatin sodium,n=49)and study group(treated with meropenem,n=54)according to different treatment methods.The distribution of pathogenic bacteria and drug resistance were detected.The blood gas indexes[arterial partial pressure of oxygen(PaO_(2)),arterial partial pressure of carbon dioxide(PaCO_(2)),arterial blood oxygen saturation(SaO_(2)),oxygenation index(OI)],inflammatory factors[interleukin-6(IL-6),procalcitonin(PCT)and tumor necrosis factor-α(TNF-α)]levels and symptom improvement were compared between the two groups.Result There were 103 strains of pathogens in LC patients complicated with LRTI,of which Gram-negative bacteria accounted for a relatively high proportion(62.05%).The top three bacteria were Pseudomonas aeruginosa(30.10%),Klebsiella pneumoniae(14.56%)and Staphylococcus haemolyticus(11.65%).Pseudomonas aeruginosa and Klebsiella pneumoniae had the lowest resistance rate to meropenem.After treatment,PaO_(2),SaO_(2)and OI of the two groups were higher than those before treatment,and PaCO_(2)were lower than those before treatment,and the PaO_(2),SaO_(2)and OI of the study group were higher than those of the control group,and PaCO_(2)was lower than that of the control group,the differences were statistically significant(P<0.05).After treatment,the levels of TNF-α,PCT and IL-6 in the two groups were lower than those before treatment,and the levels of TNF-α,PCT and IL-6 in the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).The antipyretic time,cough disappearance time,lung rales disappearance time and sputum smear negative conversion time of the study group were significantly shorter than those of the control group,and the differences w

关 键 词：肺癌 下呼吸道感染 病原菌 美罗培南 治疗效果 

分 类 号：R734.2[医药卫生—肿瘤]