头孢哌酮舒巴坦联合美罗培南对重症肺炎患者动脉血气指标及血清TNF-α、PCT、CRP水平的影响

Effects of Cefoperazone Sulbactam Combined with Meropenem on Arterial Blood Gas Indexes and Serum Levels of TNF-α, PCT and CRP in Patients with Severe Pneumonia

目的:探讨头孢哌酮舒巴坦联合美罗培南对重症肺炎(SP)患者动脉血气指标及血清肿瘤坏死因子-α(TNF-α)、降钙素原(PCT)、C反应蛋白(CRP)水平的影响。方法:选取2018年8月2020年8月期间我院收治的SP患者78例,根据入院奇偶顺序分为对照组(头孢哌酮舒巴坦治疗)和观察组(头孢哌酮舒巴坦联合美罗培南治疗),各39例,疗程为7 d,观察两组治疗7 d后的疗效,对比两组治疗前、治疗7 d后的动脉血气指标及血清TNF-α、PCT、CRP水平,观察两组临床症状缓解时间和不良反应发生情况。结果:观察组的临床总有效率高于对照组(P<0.05)。观察组肺部啰音消失时间、退热时间、脓性痰消失时间短于对照组,组间对比有差异(P<0.05)。治疗7 d后,观察组氧分压(pO2)、氧合指数(OI)高于对照组,二氧化碳分压(pCO2)低于对照组(P<0.05)。治疗7 d后,观察组TNF-α、PCT、CRP低于对照组(P<0.05)。两组不良反应发生率组间对比无差异(P>0.05)。结论:头孢哌酮舒巴坦联合美罗培南治疗SP患者,可促进患者症状改善,且改善患者动脉血气指标,降低机体炎症反应,无严重不良反应发生,安全有效。

Objective: To investigate the effects of cefoperazone sulbactam combined with meropenem on arterial blood gas indexes and serum levels of tumor necrosis factor-α(TNF-α), procalcitonin(PCT) and C-reactive protein(CRP) in patients with severe pneumonia(SP). Methods: 78 patients with SP who were admitted in our hospital from August 2018 to August 2020 were selected, and they were divided into control group(cefoperazone sulbactam) and observation group(cefoperazone sulbactam combined with meropenem)according to the admission parity order, 39 cases in each group, the course of treatment was 7 d. The curative effect of the two groups 7 d after treatment was observed. The arterial blood gas indexes and serum TNF-α, PCT and CRP levels before and 7 d after treatment were compared. The clinical symptom relief time and adverse reactions of the two groups were observed. Results: The total effective rate of the observation group was higher than that of the control group(P<0.05). The disappearance time of pulmonary rales, antipyretic time and purulent sputum in the observation group were shorter than those in the control group(P<0.05). 7 d after treatment, the oxygen partial pressure(pO2) and oxygenation index(OI) of the observation group were higher than those of the control group, and the carbon dioxide partial pressure(pCO2) of the observation group was lower than that of the control group(P<0.05). 7 d after treatment, the levels of TNF-α, PCT and CRP in the observation group were lower than those in the control group(P<0.05). There was no difference in the incidence of adverse reactions between the two groups(P>0.05). Conclusion: Cefoperazone sulbactam combined with meropenem in the treatment of SP patients can promote the improvement of symptoms, improve the arterial blood gas index, reduce the body inflammatory reaction, without serious adverse reactions, which is safe and effective.