替加环素联合头孢哌酮舒巴坦对多重耐药鲍曼不动杆菌肺部感染患者的临床疗效及机制探讨

Clinical effect and mechanism of tigecycline combined with cefoperazone and sulbactam against lung infection of multiple drug resistant Acinetobacter Bauman

目的:探讨替加环素联合头孢哌酮舒巴坦对多重耐药鲍曼不动杆菌肺部感染患者血清降钙素原(procalcitonin,PCT)水平的影响。方法:选取来海南省人民医院治疗的多重耐药鲍曼不动杆菌肺部感染患者70例,按随机数字表法分组,对照组35例予以头孢哌酮舒巴坦治疗,研究组35例在对照组基础上予以替加环素治疗,采血测定两组患者临床相应指标及免疫水平,对比临床疗效及细菌清除率状况。结果:对照组治疗有效率80%低于研究组治疗有效率91.44%,无统计学差异(P>0.05);对照组细菌清除率71.43%低于研究组细菌清除率91.44%,具有统计学意义(P<0.05);与对照组比较,研究组治疗后血清乳酸(lactate,LAC)、PCT水平均显著降低,治疗后IgA降低,IgM、IgG升高,具有统计学意义(P<0.05)。结论:替加环素联合头孢哌酮舒巴坦对多重耐药鲍曼不动杆菌肺部感染效果显著,降低PCT水平,提高免疫功能。

OBJECTIVE To investigate the clinical effect and mechanism of tigecycline combined with cefoperazone and sulbactam against lung infection of multiple drug resistant Acinetobacter Bauman.METHODS Seventy cases with lung infection of multiple drug resistant Acinetobacter Bauman in our hospital were selected and divided into 2 groups randomly.Thirty five cases in the control group received cefoperazone and sulbactam,and 35 cases in the test group received cefoperazone,sulbactam and tigecycline.Clinical parameters and immunity were determined to compare curative effect and bacterial clearance rate.RESULTS The effective rate in the control group（80%）was lower than that in test group（91.44%）,however with no significant difference（P〉0.05）.The bacterial clearance rate in control group（71.43%）was lower than that of test group（91.44%）（P〈0.05）.Compared with the control group,the levels of serum LAC,PCT,NO,Et in test group were significantly lower,and the IgA and IgG were significantly higher（P〈0.05）.CONCLUSION Tigecycline combined with cefoperazone and sulbactam is effective against lung infection of multiple drug resistant Acinetobacter Bauman,and can reduce the level of PCT and promote immune functions.