乌司他丁联合利奈唑胺对重症肺炎患者血清PCT、CRP、TNF-α及白细胞计数的影响

Effects of Ulinastatin Combined with Linezolid on the Serum PCT,CRP,TNF-α Levels and White Blood Cell Counts of Severe Pneumonia Patients

目的:探讨乌司他丁联合利奈唑胺对重症肺炎患者血清降钙素原(PCT)、C-反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)及白细胞计数的影响。方法:选择2014年2月-2018年2月在我院住院诊治的重症肺炎患者128例,根据治疗方法的不同分为观察组68例与对照组60例,对照组给予利奈唑胺治疗,观察组在对照组治疗的基础上给予乌司他丁治疗,两组都治疗观察2周,检测和比较两组治疗后临床疗效,治疗前后1秒钟用力呼气量占用力肺活量比值(FEV1/FVC)、血清PCT、CRP、TNF-α水平及白细胞计数的变化情况。结果:观察组与对照组的治疗总有效率分别为94.1%和76.7%,观察组的总有效率显著高于对照组(P<0.05)。观察组与对照组治疗后的FEV1/FVC值、白细胞计数均显著高于治疗前(P<0.05),且观察组以上指标明显高于对照组(P<0.05)。观察组与对照组治疗后的血清PCT、CRP、TNF-α水平都显著低于治疗前(P<0.05),且观察组以上指标均显著低于对照组(P<0.05)。结论:乌司他丁联合利奈唑胺治疗重症肺炎患者能显著提高临床疗效,改善患者肺功能,可能与其降低血清PCT、CRP、TNF-α水平,提高白细胞计数有关。

Objective: To investigate the effect of ulinastatin and linezolid on the serum calcitonin(PCT), C-reactive protein(CRP), tumor necrosis factor-α(TNF-α) levels and leukocyte count of patients with severe pneumonia. Methods: 128 cases of patients with severe pneumonia in our hospital from February 2014 to February 2018 were selected. According to different treatment methods,they were divided into the observation group(68 cases) and the control group(60 cases), the control group was treated with linezolid,while the observation group was treated with ulinastatin on the basis of control group, and the patients in both groups were treated for 2 weeks. The clinical efficacy after treatment, changes of forced expiratory volume in one second to forced vital capacity ratio(FEV1/FVC), serum PCT, CRP, TNF-α levels and white blood cell count before and after treatment were measured and compared between two groups. Results: The total effective rate of observation group and control group were 94.1% and 76.7% respectively, which was significantly higher in the observation group than that of the control group(P<0.05). The FEV1/FVC value and white blood cell count of both groups were significantly higher than those before treatment(P<0.05), which were significantly higher in the observation group than those of the control group(P<0.05). The levels of serum PCT, CRP and TNF-α levels in both groups were significantly lower than those before treatment(P<0.05), which were significantly lower in the observation group than those in the control group(P<0.05).Conclusion: Ulinastatin combined with linezolid can significantly improve the clinical efficacy and the lung function in the treatment of patients with severe pneumonia. It may be related to reduce the levels of serum PCT, CRP, TNF-α and increase the white blood cell count.