哌拉西林钠舒巴坦钠联合左氧氟沙星治疗老年社区获得性肺炎及对可溶性髓样细胞触发受体1和高迁移率族蛋白B1水平的影响

Efficacy of piperacillin sodium/sulbactam sodium combined with levofloxacin in the treatment of community-acquired pneumonia in the elderly and its effects on levels of serum sTREM-1 and HMGB1

目的探讨哌拉西林钠舒巴坦钠联合左氧氟沙星治疗老年社区获得性肺炎的疗效及其对血清可溶性髓样细胞触发受体1(sTREM-1)和高迁移率族蛋白B1(HMGB1)水平的影响。方法选择2017年6月-2019年6月在本院住院的老年社区获得性肺炎患者96例,采用随机数字表均分为3组:对照组1、对照组2和观察组,每组32例。对照组1给予左氧氟沙星治疗,对照组2给予哌拉西林钠舒巴坦钠治疗,观察组给予哌拉西林钠舒巴坦钠联合左氧氟沙星治疗。评估并比较3组治疗7 d时的临床疗效、细菌清除率、治疗不良反应,以及治疗前后的血清sTREM-1及HMGB1水平。结果观察组临床总有效率和细菌清除率均显著高于另外两组(P<0.05);治疗7 d时,3组血清s TREM-1及HMGB1水平均较同组治疗前显著降低(P<0.05),且观察组显著低于另外两组(P<0.05);3组不良反应发生率对比,差异均无统计学意义(P<0.05)。结论哌拉西林钠舒巴坦钠联合左氧氟沙星治疗老年社区获得性肺炎的疗效确切,能提高临床细菌清除率,有效降低血清s TREM-1及HMGB1水平,且不增加不良反应,有一定的临床应用价值。

Objective To explore the efficacy of piperacillin sodium/sulbactam sodium combined with levofloxacin in the treatment of community-acquired pneumonia in the elderly and its effects on serum soluble triggering receptors expressed on myeloid cells-1(sTREM-1)and highmobility group protein B1(HMGB1).Methods 96 elderly patientswith community-acquired pneumonia who were hospitalized in our hospital from June 2017 to June 2019 were randomly divided into observation group,control group 1 and control group 2,with 32 cases in each group.Control group 1 was treated with levofloxacin,and control group 2 was treated with piperacillin sodium/sulbactam sodium,and observation group was treated with piperacillin sodium/sulbactamsodiumcombined with levofloxacin.The clinical efficacy,bacterial clearance rate and adverse reactions after 7 d of treatment,and serum sTREM-1 and HMGB1 levels before and after treatment were evaluated and compared among the three groups.Results The clinical total effective rate and bacterial clearance rate of the observation group were significantly higher than those of other two groups(P<0.05).After 7 d of treatment,levels of serum sTREM-1 and HMGB1 of three groups were significantly lower than those before treatment(P<0.05),and levels of observation group were significantly lower than those of other two group(P<0.05).There were no significant differences in the incidence of adverse reactions among the three groups(P>0.05).Conclusion Piperacillin sodium/sulbactam sodium combined with levofloxacin in the treatment of community-acquired pneumonia in the elderly has a definite effect,can improve clinical bacterial clearance,effectively reduce serum sTREM-1 and HMGB1 levels,without increasing adverse reactions,and has certain clinical application value.