利奈唑胺治疗44例颅脑损伤术后肺部感染患者疗效及血小板减少发生因素分析

Analysis of Efficacy and Thrombocytopenia in 44 Patients with Pulmonary Infection After Brain Injury

目的分析利奈唑胺治疗44例颅脑损伤术后肺部感染患者的疗效及血小板减少发生因素。方法选取我院2018年1月至2019年12月颅脑损伤术后肺部感染患者88例,其中44例给予美罗培南为对照组,另44例在对照组基础上给予利奈唑胺为观察组,比较两组治疗效果、临床症状消失时间、治疗前后炎性因子[血清降钙素原(PCT)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)]、血小板减少发生率,分析血小板减少的影响因素。结果观察组总有效率90.91%(40/44)较对照组75.00%(33/44)高(P<0.05);观察组肺口罗音、咳痰、咳嗽、发热等症状消失时间均较对照组短(P<0.05);治疗后两组血清PCT、CRP、TNF-α水平均明显降低,且观察组较对照组低(P<0.05);观察组血小板减少发生率20.45%(9/44)高于对照组0.00%(0/44)(P<0.05);与血小板未减少者相比,血小板减少者血小板计数(用药前)较少、血清白蛋白水平较低、总胆红素水平较高、肌酐清除率较高、用药时间长(P<0.05);Logistic回归分析显示,血小板计数高(95%CI为0.305~0.662,OR=0.449)、血清白蛋白水平高(95%CI为0.405~0.733,OR=0.545)是血小板减少的保护因素,用药时间长(95%CI为2.471~6.789,OR=4.096)是血小板减少的独立危险因素(P<0.05)。结论利奈唑胺应用于颅脑损伤术后肺部感染患者,可提高治疗效果,缩短症状缓解时间,加强炎症控制效果,同时临床应注重对血小板计数的检测,重点关注用药时间偏长患者。

Objective To analyze the efficacy of linezoline in 44 patients with lung infection after brain inju-ry.Methods We selected 88 patients with lung infection after craniocerebral injury from January 2018 to Decem-ber 2019,44 were treated as the control group,and 44 gave linazolamide as the observation group to compare the treatment effect,disappearance time of clinical symptoms,inflammatory factors(PCT),serum calponin,C reactive protein(CRP),tumor necrosis factor-α(TNF-α)and the incidence of thrombocytopenia.Results The total ef-ficiency was 90.91%(40/44)higher than 75.00%(33/44)(P<0.05);The disappearance time of lung rale,sputum,cough,fever and other symptoms in the observation group were shorter than that in the control group(P<0.05);Serum PCT,CRP,TNF-αlevels were significantly reduced after treatment,And the observation group was lower than the control group(P<0.05);The incidence of thrombocytopenia in the observed group was 20.45%(9/44)higher than that of 0.00%(0/44)in the control group(P<0.05);Compared to those with a throm-bocytopenia,Plabbocytopenia had fewer platelet counts(before medication),low serum albumin levels,high total bilirubin levels,high creatinine clearance rate,and long medication time(P<0.05);Logistic regression analysis shows,Plablet count high(95%CI is 0.305~0.662,OR=0.449),High Serum albumin levels(95%CI of 0.405~0.733,OR=0.545)is a protective factor for thrombocytopenia,Long medication time(95%CI is 2.471~6.789,OR=4.096)is an independent risk factor for thrombocytopenia(P<0.05).Conclusion Linazolamine used in patients with lung infection after craniocerebral injury can improve treatment effect,shorten symptom remis-sion time and strengthen inflammation control effect,and should focus detection of platelet count and focus on pa-tients with long medication time.