莫西沙星治疗老年下呼吸道感染的疗效及其对血清炎性细胞因子的影响

Effect of moxifloxacin in treating elderly lower respiratory tract infection and its influence on serum inflammatory cytokines

目的探讨莫西沙星治疗老年下呼吸道感染(LRTI)的疗效及其对血清炎性细胞因子的影响。方法选取2014年7月至2017年6月成都军区总医院干二病房收治的老年LRTI患者126例,采用随机数字表法分为莫西沙星组和对照组,每组63例。对照组给予常规和头孢哌酮/舒巴坦治疗,莫西沙星组给予常规和莫西沙星治疗。观察两组患者咳嗽消失时间、肺部啰音消失时间、体温恢复正常时间、白细胞计数恢复正常时间、住院时间、不良反应发生情况,以及治疗前后白细胞介素-6(IL-6)、IL-8、肿瘤坏死因子-α(TNF-α)等血清炎性细胞因子水平变化。结果莫西沙星组患者咳嗽消失时间、肺部啰音消失时间、体温恢复正常时间、白细胞计数恢复正常时间、住院时间均明显短于对照组,治疗后IL-6、IL-8、TNF-α水平均明显低于对照组,总有效率明显高于对照组,差异均有统计学意义(P<0.05);两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论莫西沙星可有效改善老年LRTI患者血清炎性细胞因子水平,疗效显著,值得临床应用。

Objective To study the curative effect of moxifloxacin in the treatment of elderly patients with lower respi-ratory tract infection（LRTI）and its influence on serum inflammatory cytokines. Methods A total of 126 cases of LRTI treated in the second ward of cadres of this hospital from July 2014 to June 2017 were selected and divided into the moxifloxacin group and control group by using the random number table method,63 cases in each group. The control group was given the conventional treatment and cefoperazone/sulbactam treatment,while the Moxifloxacin group was given the conventional treatment ＋moxifloxacin treatment. The cough disappearance time,pulmonary rales disappeared time,time of temperature recovering to normal level,time of WBC count recovering to the normal,hospitalization time,occurrence of adverse reactions,levels of serum inflammatory cytokines（IL-6,IL-8,TNF-α）before and after treatment were observed in the two groups. Results The cough dis-appearance time,pulmonary rales disappeared time,time of temperature recovering to normal,time of WBC count recovering to normal and hospitalization time in the moxifloxacin group were significantly shorter than those in the control group（P〈0.05）.The IL-6,IL-8 and TNF-α levels after treatment in the moxifloxacin group were significantly lower than those in the control group,the total effective rate in the moxifloxacin group was significantly higher than that in the control group,the differences were statistically significant（P〈0.05）. The incidence rate of adverse reactions had no statistically significant difference between the two groups（P〉0.05）. Conclusion Moxifloxacin can effectively improve the serum inflammatory cytokine level in elderly patients with LRTI. The curative effect is remarkable,and it is worthy of clinical application.