急性上呼吸道感染的抗生素治疗策略研究

Study of the Therapeutical Strategy of Antibiotics in Acute Upper Respiratory Infection

目的:研究急性上呼吸道感染(AURTI)抗生素治疗的策略。方法:将645例AURTI患者按有无鼻塞、流涕、打喷嚏等卡他及过敏症状分为发热卡他组(312例)和单纯发热组(333例),按有无应用抗生素将以上两组再分为两个亚组。比较两组患者治疗前血常规的白细胞、中性粒细胞计数及血C反应蛋白(CRP)数值,并分别比较这两亚组病人应用抗生素的疗效。结果:单纯发热组治疗前的白细胞总数、中性粒细胞数及CRP值均明显大于发热卡他组,P<0.05;发热卡他组2个亚组之间的抗生素疗效无统计学差异,单纯发热组中使用抗生素的亚组疗效明显高于非抗生素亚组,P<0.05。结论:单纯发热的AURTI患者主要为细菌感染引起,抗生素治疗有效:发热伴明显卡他症状者主要为病毒感染引起,抗生素治疗效果不佳。

Objective： To study the therapeutic strategy of antibiotics in acute upper respiratory infection （AURTI）. Methods： 645 patients with AURTI were divided randomly into the catarrhal fever group（n=312） and the simple fever group（n=333） according to the concomitant catarrhal symptoms. The above 2 groups were divided into 2 subgroups separately according to using antibiotics or not. The quantity of leukocytes and neutrophil, the numerus of CRP and the treatment effectiveness of antibiotics were compared between the subgroups. Results： The quantity of leukocytes and neutrophil, the numerus of CRP in the simple fever group were significantly greater than those in the catarrhal fever group,P〈0.05. The treatment effectiveness of antibiotics was no significantly different between the 2 subgroups in the catarrhal fever group. The treatment effectiveness were significantly better in the antibiotic subgroup than those in the no- antibiotic subgroup in the simple fever group,P〈0.05. Conclusion： The AURTI with simple fever were mainly caused by bacterial infections and were effective to antibiotics. On the contrary, the patients with catarrhal symptoms were mainly caused by viral infections and were no effective to antibiotics.