替加环素对重症呼吸机相关性肺炎患者呼吸力学与血清炎症因子的影响

The Application of Tigecycline in the Treatment of Severe Ventilator-associated Pneumonia and its Influence on Respiratory Mechanics and Serum Inflammatory Factors

目的:研究替加环素治疗重症呼吸机相关性肺炎的疗效及对患者呼吸力学及血清炎症因子水平的影响。方法:选取2014年9月至2016年8月本院收治的88例重症呼吸机相关性肺炎患者,根据投硬币法分为观察组和对照组,44例每组。对照组采用常规治疗方案,观察组在常规治疗基础上采用替加环素治疗。观察并比较两组患者治疗前后呼吸力学、血清炎症因子指标及临床疗效。结果:治疗后,观察组临床总有效率高于对照组(P<0.05)。观察组肺部感染控制时间、治愈时间均短于对照组(P<0.05)。观察组呼吸做功、气道峰压、气道阻力均低于对照组,动态顺应性高于对照组(P<0.05)。观察组IL-6、IL-8、TNF-α水平低于对照组(P<0.05)。结论:重症呼吸机相关性肺炎患者经替加环素治疗后,能有效改善患者呼吸力学与血清炎症因子水平,临床疗效良好。

Objective： To study the clinical efficacy of tigecycline on the treatment of severe ventilator-associated pneumonia and its influence on the respiratory mechanics and serum inflammatory factors levels of patients. Methods： 88 patients with severe ventilator- associated pneumonia admitted in our hospital from September 2014 to August 2016 were selected and randomly divided into the observation group and the control group, with 44 cases in each group. The patients in the control group were treated with conventional method, while the patients in the observation group were treated with tigecycline on the basis of the control group. Then the clinical curative effect and indexes of respiratory mechanics and serum inflammatory factors were observed and compared between the two groups before and after the treatment. Results： After treatment, the total clinical efficacy of the observation group was significantly higher than that of the control group （P〈0.05）. The time of pulmonary infection control and cure in the observation group were significantly shorter than those of the control group （P〈0.05）. The respiratory work, peak airway pressure and respiratory resistance in the observation group were signif- icantly lower than those of the control group, while the dynamic compliance was significantly higher （P〈0.05）. The serum levels of IL-6, IL-8 and TNF-e（ in the observation group were significantly lower than those of the control group （P〈0.05）. Conclusion： Tigecycline can improve the respiratory mechanics and serum inflammatory factors in patients with severe ventilator - associated pneumonia, with better clinical curative effect.