头孢哌酮舒巴坦联合替加环素对多重耐药鲍曼不动杆菌肺炎患者炎症反应的影响

Effects of cefoperazone sulbactam combined with tigecycline against inflammatory response in patients with multidrug resistant Bauman's pneumonia

目的:探讨头孢哌酮舒巴坦联合替加环素对多重耐药鲍曼不动杆菌肺炎患者炎症反应的影响。方法:将70例多重耐药鲍曼不动杆菌肺炎患者分为2组,每组35例。对照组给予替加环素治疗;研究组在对照组基础上给予头孢哌酮舒巴坦治疗;采用急性生理与慢性健康评分Ⅱ(APACHEⅡ)及临床肺部感染评分(CPIS)评估患者病情发展情况;对比2组疗效、细菌清除率及治疗前后炎症反应变化。结果:2组治疗后的APACHEⅡ评分、CPIS评分较治疗前均明显降低(P<0.05);治疗后,研究组的APACHEⅡ评分、CPIS评分明显低于对照组,差异有统计学意义(P<0.05);研究组治疗后的总有效率明显高于对照组(77.14%vs.37.14%),差异具有显著性意义(P<0.05);研究组患者细菌清除率达到65.71%,明显高于对照组37.14%,差异有统计学意义(P<0.05);治疗后,2组降钙素原(PCT)、C反应蛋白(CRP)、白细胞计数(WBC)水平均显著降低(P<0.05);研究组治疗后PCT、CRP、WBC的水平显著低于对照组治疗后,差异有统计学意义(P<0.05)。结论:头孢哌酮舒巴坦联合替加环素治疗多重耐药鲍曼不动杆菌肺炎,能显著提高细菌清除率,进一步减轻炎症反应。

OBJECTIVE To investigate the effects of cefoperazone sulbactam combined with cyclosporine against inflammatory response in patients with multidrug resistant Bauman＇s pneumonia.METHODS Seventy cases of multidrug resistant Acinetobacter pneumonia patients were divided into two groups,35 cases in each group.Patients were treated with tegafur in the control group,with cefoperazone sulbactam combind tegafur in the study group.The patient＇s conditions were evaluated by acute physiology and chronic health scoringⅡ（APACHE Ⅱ）and clinical pulmonary infection score（CPIS）.Efficacy,bacterial clearance rate and adverse reactions were compared between the two groups.The changes of inflammatory response before and after treatment were recorded between two groups.RESULTS The scores of APACHE Ⅱ and CPIS in the two groups were significantly lower than those before treatment（P0.05）.After treatment,the APACHE Ⅱ score and CPIS score of the study group were significantly lower than those of the control group.The difference was statistically significant（P0.05）.The total effective rate of the study group was significantly higher than that of the control group（77.14%vs.37.14%）（P0.05）.The bacterial clearance rate of the study group was 65.71%,which was significantly higher than37.14% of the control group（P0.05）.After treatment,the levels of PCT,CRP and WBC were significantly decreased in the two groups（P0.05）,particularly in the study group（P0.05）.CONCLUSION Cefoperazone sulbactam combined with tigecycline has improve clearance rate against multidrug resistant Acinetobacter Bauman pneumonia,and can further reduce inflammation.