利奈唑胺联合亚胺培南西司他丁治疗肺结核伴重症肺炎的效果

Effect of Linezolid Combined with Imipenem-Cilastatin on Pulmonary Tuberculosis Complicated by with Severe Pneumonia

目的观察利奈唑胺联合亚胺培南西司他丁治疗肺结核伴重症肺炎的临床疗效及其对患者外周血炎症指标与免疫功能指标的影响。方法将68例肺结核伴重症肺炎患者采用随机数表法分为对照组与观察组,每组34例。对照组给予利奈唑胺进行治疗,观察组给予利奈唑胺联合亚胺培南西司他丁治疗,均治疗1个月。比较2组治疗前后血清炎症因子[肿瘤坏死因子-α(TNF-α)、白细胞介素(IL-6)]、细胞免疫功能(CD4+、CD8+)水平变化;比较2组治疗后临床疗效及治疗期间药物不良反应发生率。结果观察组治疗总有效率明显高于对照组(94.12%比70.59%,χ^2=5.314、P=0.021)。2组治疗后TNF-α、IL-6水平较治疗前均明显下降,CD4+、CD8+水平较治疗前均明显上升,且观察组治疗后较对照组改善更为显著,差异均有统计学意义(P<0.05)。2组治疗期间药物不良反应发生率比较差异无统计学意义(14.70%比11.76%,χ^2=0.142、P=0.707)。结论利奈唑胺联合亚胺培南西司他丁治疗肺结核伴重症肺炎疗效确切,可提高患者免疫力,有效缓解疾病症状。

Objective To study the clinical effects of linezolid combined with imipenem-cilastatin on peripheral blood inflammation indices and immune function indicators in patients with pulmonary tuberculosis complicated by severe pneumonia.Methods Sixty-eight patients with pulmonary tuberculosis and severe pneumonia were randomly treated with linezolid alone(control group,n=34)or in combination with imipenem-cilastatin(observation group,n=34)for 1 month.Serum concentrations of tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6),levels of CD4+and CD8+T cells,clinical efficacy and incidence of adverse drug reactions were compared between the two groups.Results The total effective rate in observation group was higher than that in control group(94.12%vs 70.59%,χ^2=5.314,P=0.021).After treatment,the concentrations of TNF-αand IL-6 decreased and the levels of CD4+and CD8+T cells increased in both groups,and the improvement in observation group was more obvious than that in control group(P<0.05).There was no significant difference in the incidence of adverse drug reactions between the two groups(14.70%vs 11.76%,χ^2=0.142,P=0.707).Conclusion The combined treatment with linezolid and imipenem-cilastatin can effectively improve immunity and relieve symptoms in patients with pulmonary tuberculosis complicated by severe pneumonia.