阿米卡星联合头孢哌酮/舒巴坦治疗老年慢性心力衰竭合并肺部感染的疗效观察

Efficacy of amikacin combined with cefoperazone/sulbactam in the elderly patients with chronic heart failure and pulmonary infection

目的探讨阿米卡星联合头孢哌酮/舒巴坦治疗老年慢性心力衰竭(CHF)合并肺部感染的疗效。方法纳入2009年1月至2016年12月在广州市红十字会医院接受治疗的老年CHF并肺部感染患者100例。按随机数字表法将入组患者分为对照组和观察组,每组50例。对照组给予头孢哌酮/舒巴坦静脉滴注;观察组在对照组治疗基础上加用阿米卡星静脉滴注。两组疗程均为7~14 d。比较两组呼吸频率、心率、动脉血二氧化碳分压(PaCO_2)、动脉血氧分压(PaO_2)、症状缓解时间、疗效及细菌清除率。采用SPSS 20.0软件进行统计分析。根据数据类型分别采用t检验或x^2检验进行组间比较。结果与治疗前相比,两组患者治疗后的呼吸、心率、PaCO_2及PaO_2均得到显著改善(P<0.05)。治疗后,与对照组相比较,观察组患者呼吸、心率及PaCO_2均显著降低,而PaO_2显著升高,差异均具有统计学意义(P<0.05)。观察组患者湿啰音[(4.3±1.2)vs(6.0±2.1)d]、气喘[(2.2±1.4)vs(3.5±1.7)d]、咳嗽[(5.22±1.3)vs(7.4±1.8))d]及高热[(2.4±1.1)vs(3.5±1.2)d]的缓解时间显著短于对照组(P<0.05),疗效(94.0%vs76.0%)和细菌清除率(71.4%vs47.4%)显著高于对照组(P<0.05)。结论阿米卡星联合头孢哌酮/舒巴坦治疗老年CHF并肺部感染优于单纯头孢哌酮/舒巴坦治疗。

Objective To investigate the efficacy of amikacin combined with cefoperazone/sulbactam in the treatment of chronic heart failure（CHF）and pulmonary infection in the elderly.Methods A total of 100 patients with CHF and pulmonary infection admitted in our hospital from January 2009 to December 2016 were enrolled in this study.According to the random number table,the patients were divided into control group and observation group（n=50）.The control group was given intravenous infusion of cefopera-zone/sulbactam.The observation group received intravenous infusion of cefoperazone/sulbactam plus amikacin.After the treatment course of 7-14 d,the respiratory rate,heart rate,partial pressure of arterial carbon dioxide（PaCO2）and oxygen（PaO2）, time to symptom relief, efficacy and bacterial clearance were compared between the 2 groups.SPSS statistics 20.0 was used for statistical analysis.According to the data type,Student＇s t test and Chi-square test were used to make comparison between the 2 groups.Results Compared with before treatment, the respiratory rate, heart rate, PaCO2and PaO2were significantly improved in both groups （P〈0.05）.After the treatment,the observation group had significantly reduced respiratory rate,heart rate and PaCO2,and obviously elevated PaO2when compared with the control group（P〈0.05）.The time periods to reliefs of moist rale[（4.3 ±1.2）vs（6.0 ±2.1）d], asthma[（2.2 ±1.4）vs（3.5 ±1.7）d],cough[（5.2 ±1.3）vs（7.4 ±1.8）d],and high fever[（2.4 ±1.1）vs（3.5 ±1.2）d] were notably shorter in the observation group than the control group（P〈0.05）.What＇s more,the observation group had remarkably higher efficacy（94.0%vs 76.0%）and bacterial clearance（71.4% vs 47.4%）than the control group（P〈0.05）.Conclusion Amikacin combined with cefoperazone/sulbactam is superior to cefoperazone/sulbactam in the treatment of the elderly with CHF and pulmonary infection.