头孢哌酮/舒巴坦联合阿奇霉素治疗慢性阻塞性肺疾病患者下呼吸道感染的疗效

Effect of cefoperazone/sulbactam combined with azithromycin for treatment of chronic obstructive pulmonary disease complicated by lower respiratory tract infections

目的观察头孢哌酮/舒巴坦联合阿奇霉素治疗慢性阻塞性肺疾病(COPD)患者下呼吸道感染的疗效,为临床治疗提供参考依据。方法 2010年1月-2013年8月将152例COPD下呼吸道感染患者随机分为治疗组和对照组,每组各76例,治疗组患者采用头孢哌酮/舒巴坦联合阿奇霉素治疗,对照组采用头孢哌酮/舒巴坦治疗,观察两组患者的临床疗效、临床症状及胸部影像的改善时间、细菌清除率及血浆炎症因子变化,数据采用SPSS13.0软件进行统计分析。结果治疗总有效率治疗组为93.42%,对照组为75.00%,两组比较差异有统计学意义(P<0.05);治疗组临床症状、胸部影像改善及血浆炎症因子下降明显,细菌清除率为91.30%,与对照组比较,差异均有统计学意义(P<0.05);治疗组有4例患者出现不良反应,发生率5.26%,对照组有3例出现不良反应,发生率3.95%,两组患者不良反应发生比较,差异无统计学意义。结论头孢哌酮/舒巴坦联合阿奇霉素治疗COPD下呼吸道感染患者,能够显著提高疗效,且不良反应发生无增加趋势。

OBJECTIVE To observe the effect of cefoperazone/sulbactam combined with azithromycin in the treatment of chronic obstructive pulmonary disease（COPD）complicated by lower respiratory tract infections and provide reference for clinical treatment.METHODS A total of 152 patients with COPD complicated by lower respiratory tract infections were randomly divided into the treatment group receiving cefoperazone/sulbactam combined with azithromycin and the control group receiving cefoperazone/sulbactam,with 76 cases in each.The clinical efficacy,clinical symptom,improvement time of chest imaging,sputum negative conversion rate,change of plasma inflammatory cytokines were compared between the two groups.Data were statistically analyzed by SPSS 13.0.RESULTS The total effective rate in the treatment group was 93.4% which was significantly higher than 75.0% in the control group,the difference was significant（P〈0.05）.The improvement of clinical symptoms and chest imaging and the decrease of plasma inflammatory cytokines in the treatment group was obvious,the difference was significant（P〈0.05）.The sputum negative conversion rate in treatment group was91.30%,the difference of the two groups was significant（P〈0.05）.There was no significant difference in adverse reactions between the two groups as there were 4cases（the incidence rate 5.26%）of adverse reactions in the treatment group and 3cases（3.95%）in the control group.CONCLUSION The application of cefoperazone/sulbactam combined with azithromycin in the treatment of COPD complicated by lower respiratory tract infections can improve the clinical efficacy,and does not increase adverse reactions.