纤维支气管镜吸痰联合抗感染对重症肺炎患者治疗效果及PCT、IL-6、CRP水平的影响

Effect of sputum aspiration with fiber bronchoscope combined with anti-infection therapy on symptoms and the level of PCT, IL-6 and CRP in patients with severe pneumonia

目的 探讨纤维支气管镜吸痰治疗联合抗感染对重症肺炎患者的症状缓解情况及血清降钙素原(procalcitonin,PCT)、白介素-6(interleukin 6,IL-6)、C反应蛋白(C-reactive protein,CRP)水平的影响。方法选取2015年10月至2017年10月于青岛市市立医院呼吸科住院治疗的152例重症肺炎患者,根据治疗方法分为实验组和对照组各76例,实验组予以抗感染联合纤维支气管镜吸痰治疗,对照组予以常规抗感染治疗,比较两组患者治疗后疗效、血气指标及PCT、IL-6、CRP水平。结果实验组治疗总有效率为92.11%,高于对照组(75.00%),差异有显著性(P<0.05)。两组治疗前PCT、IL-6、CRP水平差异无显著性(P>0.05),治疗后的PCT、IL-6、CRP水平均较治疗前降低,且实验组低于对照组,差异有显著性(P<0.05)。两组治疗前的血气指标水平差异无显著性(P>0.05),治疗后的PaO_2、SaO_2、PaO_2/FiO_2水平均较治疗前升高,且实验组高于对照组,差异有显著性(P<0.05)。结论纤维支气管镜吸痰治疗联合抗感染能有效降低重症肺炎患者血清PCT、IL-6、CRP水平,改善血气指标水平,值得推广。

Objective To investigate the effect of sputum aspiration with fiber bronchoscope combined with anti-infection therapy on symptoms and the level of PCT, IL-6 and CRP in patients with severe pneumonia. Method 152 patients with severe pneumonia in Pneumology department of Qingdao municipal hospital from October 2015 to October 2017 were selected and divided into study group and control group according to the treatment（76 patients each group）. The patients in control group were given conventional therapy, and the patients in study group were given sputum aspiration with fiber bronchoscope therapy and conventional therapy. The Efficacy, blood gas index and the level of PCT, IL-6, CRP of patients after treatment were compared between the two groups. Result After treatment, the total effective rate of the study group was 92.1 1%,and the effective rate of control group was 75.00%. The total effective rate of study group was higher than that of control group, and the difference was statistically（P〈0.05）. There was no difference in the levels of PCT, IL-6 and CRP between the two groups before treatment（P〈0.05）. The levels of PCT, IL-6 and CRP after treatment were significantly lower than those before treatment, and the levels of PCT, IL-6 and CRP in study group were significantly lower than those in control group, and the difference was statistically（P〈0.05）. The levels of PaO_2, SaO_2 and PaO_2/FiO_2 in the two groups after treatment were significantly higher than those before treatment（P 0.05）, and the levels in the study group were significantly higher than those in the control group（P〈0.05）.Conclusion Sputum aspiration with fiber bronchoscope combined with anti-infection therapy can reduce the serum levels of PCT, IL-6,CRP in patients with severe pneumonia effectively, and improve the levels of blood gas,so the treatment was worth promoting.