哌拉西林-他唑巴坦对小儿肾盂肾炎患儿症状缓解情况、肾功能及炎症因子的影响

Effect of Piperacillin Tazobactam on Symptom Relief,Renal Function,and Inflammatory Factors in Children with Pyelonephritis

目的探讨哌拉西林-他唑巴坦治疗小儿肾盂肾炎的效果.方法选择2020年6月—2022年10月于郯城县第一人民医院收治的74例小儿肾盂肾炎患儿为研究对象,以随机数字表法分为两组.对照组(n=37)采用替卡西林钠克拉维酸钾治疗,观察组(n=37)采用哌拉西林—他唑巴坦,均持续用药14 d.比较两组患儿的临床疗效、症状缓解情况、肾功能指标、血清炎症因子水平、细菌清除率及不良反应发生情况.结果观察组的治疗总有效率为94.59%,高于对照组的75.68%,差异有统计学意义(P<0.05).观察组的发热、腰痛、肾部叩击痛、尿路刺激等症状的消退时间均短于对照组,组间差异有统计学意义(P<0.05).治疗后,观察组的尿素氮、肌酐、胱抑素C、降钙素原、白细胞介素-6、肿瘤坏死因子-α、C反应蛋白水平均低于对照组,组间差异有统计学意义(P<0.05).治疗后,观察组的细菌清除率为68.75%,高于对照组的32.35%,差异有统计学意义(P<0.05).两组的不良反应发生率比较,差异无统计学意义(P>0.05).结论采用哌拉西林-他唑巴坦治疗小儿肾盂肾炎的效果确切,可明显缩短患儿症状消退时间,改善其肾功能,减轻患儿体内炎症反应,提高细菌清除效果,且安全性较高.

Objective To investigate the effect of piperacillin tazobactam in the treatment of pyelonephritis in children.Methods 74 children with pyelonephritis treated in the Tancheng County First People's Hospital from June 2020 to October 2022 were selected as the research objects and were divided into two groups by random number table method.The control group(n=37)was treated with ticarcillin disodium and clavulanate potassium,the observation group(n=37)was treated with piperacillin tazobactam.Both groups were treated continuously for 14 days.The clinical efficacy,symptom relief,renal function indexes,serum inflammatory factor levels,bacterial clearance rate and adverse reactions were compared between the two groups.Results The total effective rate of the observation group was 94.59%,higher than 75.68%of the control group,the difference was statistically significant(P<0.05).The regression time of fever,lumbago,renal percussion pain and urinary tract irritation in the observation group were shorter than those in the control group,and the differences between the groups were statistically significant(P<0.05).After treatment,the levels of blood urea nitrogen,creatinine,cystatin C,procalcitonin,interleukin-6,tumor necrosis factor-αand C-reactive protein in the observation group were lower than those in the control group,and the differences between the groups were statistically significant(P<0.05).After treatment,the bacterial clearance rate in the observation group was 68.75%,higher than 32.35%in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Piperacillin tazobactam is effective in the treatment of pyelonephritis in children,which can significantly shorten the time of symptom resolution,improve renal function,reduce inflammation,and improve bacterial clearance,with high safety.