胸腺肽联合头孢哌酮／舒巴坦治疗老年不动杆菌下呼吸道感染研究

Clinical observation of cefoperazone/sulbactam with Thymosin in the treatment of lower respiratory tract infection of acinetobacter bacilli among elderly patients

目的观察胸腺肽联合头孢哌酮／舒巴坦治疗老年不动杆菌下呼吸道感染患者临床疗效、细菌清除率及二重感染情况。方法随机选择64例临床确诊为老年不动杆菌下呼吸道感染者，分成胸腺肽联合头孢哌酮／舒巴坦为治疗组32例，单用头孢哌酮／舒巴坦治疗为对照组32例。观察两组的临床疗效，细菌清除率、二重感染率、化验室指标改善情况等。结果不动杆菌对头孢哌酮一舒巴坦、哌拉西林一他唑巴坦、亚胺培南的敏感率较高63．0％～83．3％，其他抗生素敏感率均减低，小于60％。治疗组总有效率78．1％，明显高于对照组的53．1％，差异有统计学意义（P〈O．05）。治疗后治疗组痰培养不动杆菌清除率81．3％，较对照组的63％有明显升高，差异有统计学意义（P〈0．05）。治疗后治疗组二重感染率14．6％，较对照组41．3％有明显降低，差异有统计学意义（P〈O．05）。结论胸腺肽可改善机体的免疫功能、炎症反应，联合头孢哌酮／舒巴坦治疗老年不动杆菌下呼吸道感染具有协同作用。胸腺肽联合头孢哌酮／舒巴坦治疗组化验室指标改善明显，细菌清除率明显提高，二重感染率明显降低，提高了临床治疗有效率。

Objective To evaluate the clinical effectiveness, bacterial clearance rate and Superinfection rate of Cefoperazone/sulbactam with thymosin in the treatment of lower respiratory tract infection of acinetobacter bacilli among elderly patients. Methods A total of 64 cases of elderly patients with lower respiratory tract infection of acinetobacter bacilli were randomly divided into study group and control group,study group were 32 cases with the therapy of Cefoperazone/sulbactam with Thymosin. Control group were 32 cases with the therapy of Cefoperazone/sulbactam. The clinical effectiveness, bacterial clearance rates,Superinfection and laboratory indexes of 2 groups were compared. Results Drug susceptible rate of cefoperazone-sulbactam, piperacillin/tazobactam and imipenem to baumannii, was relatively high （63.0%-83.3%）, other drugs susceptible rate to baumannii was less than 60%. The clinical effective rate of study group and control group were 78.1% and 53.1% respectively, there were statistical differences between 2 groups （ P 〈 0.05）. The bacterial clearance rates of study group and control group were 81.3 % and 63% respectively, there were statistical differences between 2 groups（ P 0.05）. Superinfection rates of study group and control group were 14.6% and 41.3% respectively, there were statistical differences （ P 〈 0.05）. Conclusions Thymosin improves immunologic function and inflammatory response. Cefoperazone/sulbactam and Thymosin in the treatment of lower respiratory tract infection of acinetobacter bacilli may act synergistic effect among elderly patients. The laboratory indexes of the group （Cefoperazone/sulbactam with Thymosin） was improved, Superinfection rate was reduced, and the efficiency of clinical treatment was increased.