应用不同抗菌药物治疗细菌性痢疾的效果及对CRP、TNF-α的影响

Clinical results and changes in CRP and TNF-α of patients with bacillary dysentery in treatment with different antibiotics

目的探讨应用不同抗菌药物治疗细菌性痢疾的临床效果及对C反应蛋白(CRP)、肿瘤坏死因子(TNF)-α的影响。方法选取2015年5月至2016年5月医院收治的94例细菌性痢疾患者作为研究对象,随机分为观察组47例和对照组47例。两组患者均给予退热、维持酸碱平衡、纠正电解质紊乱、解痉、口服补液盐、合理饮食等常规治疗。对照组在常规治疗基础上口服氨苄西林片;观察组在常规治疗基础上给予注射用头孢哌酮钠。对于重型或中毒性患者可在两组治疗基础上加用盐酸环丙沙星注射液灌肠。比较两组患者临床指标改善时间及治疗效果,治疗前后CRP、TNF-α水平变化情况,并记录两组患者不良反应发生情况。结果观察组临床症状改善时间、退热时间、腹泻消失时间、大便次数、大便转阴时间均明显低于对照组(P<0.05);治疗后观察组总有效率(95.7%)显著高于对照组(83.0%),差异具有统计学意义(P<0.05);治疗后两组患者CRP、TNF-α水平均明显降低(P<0.05),其中观察组CRP、TNF-α水平明显低于对照组(P<0.05);两组患者治疗过程中发生恶心、呕吐、头晕、头痛、皮疹、失眠等不良症状,未经处理均自行好转;两组患者不良反应发生情况比较,差异具有统计学意义(P<0.05)。结论与氨苄西林比较,头孢哌酮钠能有效提高细菌性痢疾的临床效果,缓解临床症状,显著降低CRP、TNF-α水平,安全可靠,具有临床推广应用价值。

Objective To investigate the clinical results and changes in C reactive protein（CRP）,tumor necrosis factor（TNF）-αof patients with bacillary dysentery in treatment with different antibiotics.Methods A total of 94 cases of patients with bacillary dysentery were selected,which were treated in hospital from May 2015 to May 2016,and were divided into the observation group（47 cases）and control group（47 cases）.The patients of two groups were all treated with conventional treatment,including defervescence,maintaining acid-base balance,correcting electrolyte imbalance,antispasmodic,oral rehydration salts and taking the reasonable diet.The patients of control group were treated with ampicillin tablets,while the patients of observation group were treated with cefoperazone sodium for injection.The patients with severe or toxic in the two groups could be treated with ciprofloxacin hydrochloride injection enema on the basis of the normal treatment.The time for the improvement of clinical indicators,clinical effect,adverse reactions and changes of the levels of CRP,TNF-αof two groups were compared.Results The clinical symptoms improved time,fever time,diarrhea disappeared time,stool frequency,stool negative time of the observation group were significantly shorter than those of the control group（P〈0.05）.The patients of the observation group got a total effective rate of 95.7%,which was significantly higher than the 83.0% of the control group（P〈0.05）.In the terms of CRP,TNF-α,the patients of two groups were all significantly lower than before（P〈0.05）,and which of the patients of the observation group were significantly lower than that of the control group（P〈0.05）.There were nausea,vomiting,dizziness,headache,rash,insomnia and other adverse reactions occurred in both two groups,and there were statistically significance between the two groups（P〈0.05）.Conclusion With treating patients with bacillary dysentery,cefoperazone can effectively improve the clinical effect compared with ampicillin,alleviate the clinical symptoms,significantly reduce the levels of CRP,TNF-α,and it is also safe and reliable,which makes it have clinical application value.