盐酸氨溴索联合头孢哌酮舒巴坦钠治疗老年社区获得性肺炎疗效及对血清PCT、hs-CRP及ESR的影响

Efficacy of Ambroxol Hydrochloride Combined with Cefoperazone-sulbactam Sodium on Community-acquired Pneumonia in the Elderly and Its Effects on Serum PCT,hs-CRP and ESR

目的观察盐酸氨溴索联合头孢哌酮舒巴坦钠(CPZ/SBT)治疗老年社区获得性肺炎(CAP)疗效及对血清降钙素原(PCT)、超敏C反应蛋白(hs-CRP)及红细胞沉降率(ESR)的影响。方法回顾性分析2016年1月-2018年12月收治的86例老年CAP患者的临床资料,按治疗方法分为左氧氟沙星(LVF)组44例和CPZ/SBT组42例。2组均给予盐酸氨溴索,LVF组在此基础上给予左氧氟沙星氯化钠注射液治疗,CPZ/SBT组给予注射用头孢哌酮舒巴坦钠治疗。治疗7 d后评估疗效,比较2组治疗前后血清炎性标志物(PCT、hs-CRP)及ESR、痰液相关指标[中性粒细胞(Neu)占比、嗜酸性粒细胞(EOS)占比、嗜酸性粒细胞趋化因子(Eotaxin)]水平,记录不良反应发生情况。结果CPZ/SBT组总有效率高于LVF组(P<0.05)。治疗7 d后,2组血清PCT、hs-CRP及ESR、Neu、EOS、Eotaxin均较治疗前降低,且CPZ/SBT组低于LVF组(P<0.01)。2组总不良反应发生率比较差异无统计学意义(P<0.05)。结论相较于盐酸氨溴索联合LVF,盐酸氨溴索联合CPZ/SBT治疗老年CAP可进一步提升疗效,减轻炎症反应,且安全性良好。

Objective To observe the efficacy of ambroxol hydrochloride combined with Cefoperazone-sulbactam sodium(CPZ/SBT)in the treatment of community-acquired pneumonia(CAP)in the elderly and its effects on serum procalcitonin(PCT)and high-sensitivity C-reactive protein(hs-CRP)and erythrocyte sedimentation rate(ESR).Methods The clinical data of 86 elderly patients with CAP treated in our hospital from January 2016 to December 2018 were retrospectively analyzed.According to different treatment methods,they were divided into Levofloxacin(LVF)group(n=44)and CPZ/SBT group(n=42).Both groups were given Ambroxol Hydrochloride.On this basis,LVF group was given LVF treatment and CPZ/SBT group was given CPZ/SBT treatment.The efficacy was evaluated at 7 d after treatment.The levels of serum inflammatory markers(PCT,hs-CRP)and ESR and sputum-related indicators[neutrophil(Neu)ratio,eosinophil(EOS),eosinophil chemotactic factor(Eotaxin)]were compared between the two groups before and after treatment,and the occurrence of adverse reactions was recorded.Results The total effective rate in CPZ/SBT group was higher than that in LVF group(P<0.05).At 7 d after treatment,the levels of PCT,hs-CRP,ESR,Neu,EOS,and Eotaxin in the two groups were lower than those before treatment,and the levels in CPZ/SBT group were lower than those in LVF group(P<0.01).There was no significant difference in the incidence rate of adverse reactions between the two groups(P<0.05).Conclusion Compared with Ambroxol Hydrochloride combined with LVF,Ambroxol Hydrochloride combined with CPZ/SBT for CAP in the elderly can further improve the efficacy and reduce inflammatory reactions,and it has good safety.