泰能联合纤维支气管镜灌洗治疗重症肺炎临床效果及对血清炎性指标的影响

Clinical curative effect of Tienam combined with bronohoalveolar lavage on severe pneumonia and its influences on serum inflammatory indexes

目的:探讨泰能联合纤维支气管镜(BAL)灌洗治疗重症肺炎临床效果及对血清炎性指标的影响。方法:选取66例重症肺炎患者为研究对象,按照治疗方式不同分为观察组和对照组,每组各33例。对照组患者采用注射用亚胺培南西司他丁钠(泰能)治疗;观察组患者在对照组治疗基础上采用BAL灌洗治疗,疗程均为两周。比较两组患者疗效,血清炎性指标C-反应蛋白(CRP)及降钙素原(PCT),白细胞数(WBC)及中性粒细胞(NEUT)比率,细胞免疫功能指标CD3^(+),CD4^(+)及CD8^(+),治疗期间不良反应发生情况。结果:两组患者治疗有效率比较,差异无统计学意义(P>0.05)。治疗后,两组患者血清CRP、WBC、PCT、NEUT比率、外周血CD3^(+)、CD4^(+)均较治疗前降低(P<0.05),且低于对照组(P<0.05);外周血CD8^(+)较治疗前升高(P<0.05),且观察组高于对照组(P<0.05)。两组患者治疗期间不良反应发生率比较,差异无统计学意义(P>0.05)。结论:泰能联合BAL治疗可以明显提高重症肺炎临床效果,改善重症肺炎临床症状,降低血清炎性指标,且安全性好。

Objective:To explore the clinical curative effect of Tienam combined with bronohoalveolar lavage(BAL)on severe pneumonia and its influences on serum inflammatory indexes.Methods:A total of 66 patients were enrolled.They were divided into observation group and control group by different treatment methods,33 cases in each group.The control group was treated with Tienam(Imipenem and Cilastatin Sodium for Injection),while observation group was treated with BAL on basis of control group.Both groups were continuously treated for 2 weeks.The curative effects,serum inflammatory indexes C-reactive protein(CRP)and procalcitonin(PCT),leukocyte count(WBC)and neutrophil(NEUT)ratio,cellular immune function indexes CD3^(+),CD4^(+)and CD8^(+),and the occurrence of adverse reactions during treatment were compared between the two groups.Results:There was no significant difference in the treatment efficiency between the two groups(P>0.05).After treatment,CRP,WBC,PCT,NEUT,and the levels of peripheral blood CD3^(+)and CD4^(+)in both groups were significantly decreased(P<0.05),which were significantly lower in observation group than in control group(P<0.05).The level of peripheral blood CD8^(+)in both groups were significantly increased(P<0.05),which was significantly higher than that in control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups during treatment(P>0.05).Conclusion:Tienam combined with BAL can significantly improve clinical curative effect on severe pneumonia,improve clinical symptoms,reduce levels of serum inflammatory indexes,and have good safety.