注射用盐酸头孢吡肟与硫酸头孢噻利治疗中重度社区获得性肺炎的临床疗效分析

Clinical analysis of cefepime hydrochloride for injection with sulfuric acid cefoselis treatment of moderate to severe community-acquired pneumonia

目的探讨注射用盐酸头孢吡肟与硫酸头孢噻利治疗中重度社区获得性肺炎的临床疗效。方法随机选取于2013年4月~2015年4月收治的77例社区获得性肺炎患者作为本次研究对象,按入院时间随机分为观察组39例,对照组38例。观察组采用盐酸头孢吡肟治疗,对照组采用硫酸头孢噻利治疗,比较两组患者治疗后各项临床症状恢复时间及临床疗效,记录两组患者病原菌清除率和不良发应发生情况。结果 77例患者在治疗前,观察组分离致病菌36株,对照组分离致病菌35组。其中,革兰氏阳性菌56株,革兰氏阴性菌13株,真菌2株;治疗后,观察组患者病原菌清除率达86.11%,对照组病原菌清除率为80.00%,两组患者病原菌清除率比较无统计学意义（P〉0.05）。治疗后,观察组患者治愈28例,治愈率71.79%,总有效率92.31%;对照组4例患者治疗无效,治愈率为50.00%,总有效率89.47%,临床疗效较观察组差,但两组比较无统计学意义（P〉0.05）。观察组患者体温恢复正常平均在（4.32±0.89）d,对照组平均（4.93±1.35）d,观察组患者各项体征恢复正常时间均明显短于对照组,两组比较有统计学意义（P〈0.05）。观察组治疗后,总不良反应发生率为12.82%,对照组为10.53%,两组比较无统计学意义（P〉0.05）。结论注射用盐酸头孢吡肟和硫酸头孢噻利治疗社区获得性肺炎均有一定疗效,但盐酸头孢吡肟对于病原菌的清除率更高,患者各项体征恢复时间短,临床疗效更好,同时不良反应少且较轻,安全性高,有利于病情控制和预后,临床治疗中可作首先药物。

Objective To study the clinical efficacy of cefepime and cefoselis for treatment in moderate to severe community-acquired pneumonia.Methods 77 patients were randomly taken from the community-acquired pneumonia patients treated in our hospital from April 2013 to April 2015 as test subjects.According to the time of admission,77 cases were randomly divided into observation group（39cases）and control group（38cases）,respectively.Cefepime Hydrochloride therapy was established for the observation group,whilst Sulfuric Acid Cefoselis treatment was used for the control group.The clinical symptoms,recovery time of patients from both groups and the clinical efficacy of treatments were observed.The pathogen clearance rate and adverse drug reactions（should they occur）of both groups were recorded,analyzed and compared.Results Of the 71 pathogens isolated from the 77 patients prior to treatment,36 strains of pathogenic bacteria were isolated from observation group while 35 strains were isolated from control group.56 were gram-positive bacteria,13 were gram-negative bacteria,2were fungi.After treatment,the observation group was at 86.11% pathogenic bacteria clearance rate,while the control group was 80.00% pathogen cleared,the comparison of both showing no statistical significance（P〈0.05）.After treatment,there were 28 cured cases among the observation group at a cure rate of 71.79%,showing a total efficiency of 92.31%.There were 19 cured cases among the control group at a cure rate of50.00%,showing a total efficiency of 89.47%,which was inferior to the observation group in terms of clinical efficacy,despite the statistical non-significance（P〈0.05）of the comparison of the two groups.The time spent for body temperature to return normal averaged（4.32±0.89）d for the observation group and（4.93±1.35）d for the control group.The observation group spent significantly shorter time than the control group in recovering body vitals,the comparison of the two groups showing statistical significance（P〈0.05）.After treatment,the overall incidence of adverse reactions was 12.82% on the observation group,10.53% on the control group.The comparison of the two groups was not statistically significant（P〈0.05）.Conclusion Treatment of community-acquired pneumonia has certain effect using either Cefepime Hydrochloride for Injection or Sulfuric Acid Cefoselis.However treatment with Cefepime Hydrochloride provides for higher clearance of pathogens,shorter body vitals recovery time,and leaves less likely and much lighter adverse reaction cases,thus suggesting better clinical efficacy with high drug safety.