用美罗培南联合莫西沙星治疗慢性阻塞性肺疾病合并肺炎的效果观察

Efficacy observation of meropenem combined with moxifloxacin in the treatment of chronic obstructive pulmonary disease complicated with pneumonia

目的:探讨对慢性阻塞性肺疾病合并肺炎患者应用美罗培南联合莫西沙星进行治疗的效果.方法:选择都江堰市人民医院2017年4月至2018年2月接诊的100例慢性阻塞性肺疾病合并肺炎患者作为研究对象.将其随机分为单一治疗组和联合治疗组.对单一治疗组患者采用莫西沙星进行治疗,对联合治疗组患者采用莫西沙星联合美罗培南进行治疗.然后比较两组患者的临床疗效、不良反应的发生率、治疗后其白细胞计数恢复正常的时间、肺部湿啰音消失的时间、住院的时间、治疗前后其血清炎性因子指标及肺功能指标.结果:联合治疗组患者治疗的总有效率高于单一治疗组患者,P<0.05.治疗后,联合治疗组患者血清CRP、IL-6、IL-8的水平均低于单一治疗组患者,其FEV1/FVC、MMF、MVV均高于单一治疗组患者,其白细胞计数恢复正常的时间、肺部湿啰音消失的时间和住院的时间均短于单一治疗组患者,P<0.05.两组患者不良反应的发生率相比,P>0.05.结论:对慢性阻塞性肺疾病合并肺炎患者应用美罗培南联合莫西沙星进行治疗的效果较好,可有效地控制其病情,降低其炎性因子的水平,改善其肺功能,且安全性较高.

Objective: To investigate the therapeutic effect of meropenem combined with moxifloxacin on patients with chronic obstructive pulmonary disease complicated with pneumonia. Methods: 100 cases of patients with chronic obstructive pulmonary disease and pneumonia admitted by dujiangyan people’s hospital from April 2017 to February 2018 were selected as research objects. They were randomly divided into monotherapy group and combination therapy group. Moxifloxacin was used to treat patients in the monotherapy group and moxifloxacin combined with meropenem was used to treat patients in the combined therapy group. Then, the clinical efficacy, incidence of adverse reactions, time of white blood cell count returning to normal after treatment, time of disappearance of moist rale in the lungs, time of hospitalization, serum inflammatory factor indexes and pulmonary function indexes before and after treatment were compared between the two groups. Results: the total effective rate of the combined treatment group was higher than that of the single treatment group, P < 0.05. After treatment, serum levels of CRP, il-6 and il-8 in the combined treatment group were lower than those in the monotherapy group, and the levels of FEV1/FVC, MMF and MVV were all higher than those in the monotherapy group. The time of white blood cell count returning to normal, the time of the disappearance of moist rale in the lungs and the time of hospitalization were shorter than those in the monotherapy group(P < 0.05). The incidence of adverse reactions between the two groups was P > 0.05. Conclusion: meropenem combined with moxifloxacin can effectively control the disease, reduce the level of inflammatory factors and improve the lung function in patients with chronic obstructive pulmonary disease complicated with pneumonia, and the safety is relatively high.