阿奇霉素和头孢曲松钠治疗重症肺炎的疗效对比分析

Comparative analysis of efficacy of azithromycin and ceftriaxone sodium in the treatment of severe pneumonia

目的对比分析阿奇霉素注射液与头孢曲松钠注射液治疗重症肺炎的临床疗效,及重症肺炎患者血清可溶性白细胞介素-2受体(SIL-2R)、C反应蛋白(CRP)及心肌酶变化。方法选取2016年1月到2023年7月蒙城县第一人民医院收治的136例重症肺炎患者为研究对象,采用简单随机化方法随机分为对照组和观察组,各68例,对照组使用头孢曲松钠注射液进行治疗,观察组使用阿奇霉素注射液进行治疗。对比2组临床症状消失时间、不良反应发生率以及临床疗效,以及血清SIL-2R、CRP及心肌酶水平。结果观察组止咳时间、退热时间、啰音消失时间、喘息消失时间均短于对照组(P<0.05);治疗后,2组血清SIL-2R、CRP、乳酸脱氢酶(LDH)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、天门冬氨酸氨基转移酶(AST)低于治疗前,且观察组血清SIL-2R、CRP、LDH、CK、CK-MB、AST低于对照组(P﹤0.05);观察组治疗总有效率高于对照组(χ^(2)=9.140,P=0.003);观察组不良反应发生率低于对照组(χ^(2)=3.886,P=0.049)。结论阿奇霉素治疗重症肺炎的效果优于孢曲松钠,能有效改善重症肺炎的临床症状,减少血清SIL-2R、CRP及心肌酶水平,不良反应少,安全可靠,值得推广。

Objective:To compare and analyze the clinical efficacy of azithromycin injection and ceftriaxone sodium injection in the treatment of severe pneumonia,and the changes of serum soluble interleukin-2 receptor(SIL-2R),C-reactive protein(CRP)and myocardial enzymes in patients with severe pneumonia.Methods:A total of 136 patients with severe pneumonia admitted to Mengcheng County First People's Hospital from January 2016 to July 2023 were selected as the study objects,and were randomly divided into control group and observation group by simple randomization method,with 68 cases in each group.The control group was treated with ceftriaxone sodium injection,and the observation group was treated with azithromycin injection.The time for clinical symptoms to disappear,the incidence of adverse reactions and clinical efficacy,as well as the levels of serum SIL-2R,CRP and myocardial enzymes were compared between the two groups.Results:The cough relieving time,fever relieving time,rales disappearing time and wheezing disappearing time in observation group were shorter than those in control group(P<0.05).After treatment,serum SIL-2R,CRP,lactate dehydrogenase(LDH),creatine kinase(CK),creatine kinase isoenzyme(CK-MB)and aspartate aminotransferase(AST)in 2 groups were lower than before treatment.Serum SIL-2R,CRP,LDH,CK,CK-MB and AST in observation group were lower than those in control group(P<0.05).The total effective rate of observation group was higher than that of control group(χ^(2)=9.140,P=0.003).The incidence of adverse reactions in observation group was lower than that in control group(χ^(2)=3.886,P=0.049).Conclusion:Azithromycin is more effective than sporotrasone sodium in the treatment of severe pneumonia,can effectively improve the clinical symptoms of severe pneumonia,reduce serum SIL-2R,CRP and myocardial enzyme levels,less adverse reactions,safe and reliable,worthy of promotion.