亚胺培南西司他丁治疗重症肺炎患者的观察

Clinical observation of Tienam in treating patients with severe pneumonia

目的评价亚胺培南西司他丁治疗重症肺炎患者的临床疗效及安全性。方法以42例重症肺炎患者为研究对象,给予亚胺培南西司他丁0.5或1 g,q8 h静滴,观察重症肺炎患者的临床和不良反应。结果应用亚胺培南西司他丁治疗重症肺炎患者的疗效明显胜于治疗前;痰液病原体的清除率为87.5%;胸部CT肺部炎性渗出病灶较前明显吸收;34例存活的重症肺炎患者未见不良反应。结论亚胺培南西司他丁对重症肺炎患者有良好的治疗效果。

Objective To evaluate clinical efficacy and safety of Tienam in treating patients with severe pneumonia. Methods 42 cases of patients with severe pneumonia were selected as subjects who were given Tienam 0.5 or 1 g, q8 h intravenously for 9.5 （ ± 2. 5） days. Body temperature change was observed, serum high-sensitivity C-reactive protein, blood routine test, alanine aminotransferase （ ALT ） , aspartate aminotransferase （AST） , blood urea nitrogen （ BUN ） , creatinine （Cr） , arterial blood oxygen pressure （ PaO2 ） and oxygenation index（PaO2/FiO2 ）were detected before and after the treatment,sputum culture was carried out, chest CT was reviewed in the subjects. Differences of related values were compared before and after the treatment,adverse reaction of Tienam was observed in the subjects. Results The main findings were as followes ： Serum high-sensitivity C-reactive protein concentration after the treatment [ （9. 1 ±3.1 ） mg/ L ] was significantly lower than that before the treatment [ （ 97.6 ±21.3 ） mg/L ] ; total number of peripheral white blood cells after the treatment[ （5.8 ± 2.5） ×10^9/L] was significantly lower than that before the treatment [ （18. 3 ± 6. 2 ） × 10^9/L] ;PaO2 after the treatment [ （85.2± 10. 2）mmHg] was significantly higher than that before the treatment[ （52. 3 ± 14.4）mmHg] ; PaO2/FiO2 after the treatment [ （411.6 ± 57.1 ）mmHg] was significantly higher than that before the treatment [ （265.6 ± 29.3 ）mmHg] ;all with obviously statistical significance in differences（ P 〈 0. 01 ） for patients with severe pneumonia. There were no statistical differences（ P 〉 0.05 ） on ALT, AST, BUN and Cr before and after the treatment. Sputum pathogen clearance rate was 87.5%. Inflammatory exudation in lungs of chest CT were obviously absorbed after the treatment. No adverse reaction was observed in 34 cases of survivors with severe pneumonia. Conclusion Tienam has good therapeutic effect for patients with severe pneumonia.