头孢哌酮钠舒巴坦钠不同给药频次用于慢性阻塞性肺疾病急性加重期患者的疗效及病原菌清除率比较

Comparison of Efficacy and Pathogen Clearance Rate of Different Dosing Frequency of Cefoperazone Sodium and Sulbactam Sodium in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

目的:比较头孢哌酮钠舒巴坦钠不同给药频次用于慢性阻塞性肺疾病急性加重期患者的疗效及对病原菌清除率的影响,为临床慢性阻塞性肺疾病患者合理应用抗菌药物提供指导。方法:选取2018年1月至2019年1月邢台医学高等专科学校第二附属医院收治的慢性阻塞性肺疾病急性加重期患者120例,以随机数字表分为研究组(n=60)和对照组(n=60)。研究组患者采用头孢哌酮钠舒巴坦钠3.0 g,每8 h给药1次;对照组患者采用头孢哌酮钠舒巴坦钠3.0 g,每12 h给药1次;两组患者均治疗10 d。观察两组患者的临床疗效、第1 s用力呼气容积(FEV1)、FEV1占用力肺活量百分比(FEV1/FVC)、血氧饱和度、动脉血氧分压、睡眠效果评分、临床症状恢复时间、实验室检查指标恢复时间、血清杀菌活性(SBA)及病原菌清除率。结果:研究组患者的临床总有效率为98.33%(59/60),明显高于对照组的90.00%(54/60),差异有统计学意义(P<0.05)。研究组患者的FEV1、FEV1/FCV、血氧饱和度、动脉血氧分压及睡眠效果评分明显优于对照组,发热、咳嗽、C反应蛋白及中性粒细胞恢复时间明显短于对照组,峰时和谷时SBA明显高于对照组,差异均有统计学意义(P<0.05)。研究组患者的病原菌清除率为88.46%(46/52),明显高于对照组的66.00%(33/50),差异有统计学意义(P<0.05)。结论:头孢哌酮钠舒巴坦钠每8 h给药1次可提高慢性阻塞性肺疾病急性加重期患者的临床疗效,改善肺功能,提高病原菌清除率,且对铜绿假单胞菌、肺炎克雷伯菌、大肠埃希菌及鲍曼不动杆菌的SBA高于每12 h给药1次。

OBJECTIVE:To compare the efficacy of different dosing frequency of cefoperazone sodium and sulbactam sodium in patients with acute exacerbation of chronic obstructive pulmonary disease and its effects on pathogen clearance rate,so as to provide guidance for the rational use of antibiotics for patients with chronic obstructive pulmonary disease in clinic.METHODS:Totally 120 patients with acute exacerbation of chronic obstructive pulmonary disease admitted into the Second Affiliated Hospital of Xingtai Medical College from Jan.2018 to Jan.2019 were extracted to be divided into the study group(n=60)and the control group(n=60)via the random number table.The study group was treated with cefoperazone sodium and sulbactam sodium 3.0 g once every 8 hours,while the control group received cefoperazone sodium and sulbactam sodium 3.0 g once every 12 hours.Both groups were treated for 10 d.The clinical efficacy,forced expiratory volume in one second(FEV1),FEV1/FVC,blood oxygen saturation,arterial partial pressure of oxygen and sleep score,recovery time of clinical symptoms,recovery time of laboratory examination,serum bactericidal activity(SBA)and pathogen clearance rate of two groups were observed.RESULTS:The total clinical effective rate was 98.33%(59/60)in the study group,significantly higher than 90.00%(54/60)in the control group,with statistically significant difference(P<0.05).FEV1,FEV1/FCV,blood oxygen saturation,arterial partial pressure of oxygen and sleep scores of the study group were significantly better than those of the control group,and the recovery time of fever,cough,C-reactive protein and neutrophil was significantly shorter than that of the control group,SBA at peak and valley time was significantly higher than that of the control group,the difference was statistically significant(P<0.05).The pathogen clearance rate in the study group was 88.46%(46/52),significantly higher than66.00%(33/50)in the control group,with statistically significant difference(P<0.05).CONCLUSIONS:Treatment with cefoperazone sodium and sulbactam sodium every 8 hours can significantly improve the clinical efficacy of patients with chronic obstructive pulmonary disease,and effectively improve lung function and pathogen clearance,the SBA of Pseudomonas aeruginosa,Klebsiella pneumoniae,Escherichia coli and Acinetobacter baumannii is higher than treatment with cefoperazone sodium and sulbactam sodium every 12 hours.