哌拉西林钠他唑巴坦钠联合阿奇霉素治疗呼吸道细菌感染的疗效

Efficacy of piperacillin sodium and tazobacta sodium combined with azithromycin in the treatment of children with respiratory tract bacterial infection

目的研究哌拉西林钠他唑巴坦钠联合阿奇霉素对小儿呼吸道细菌感染的疗效及对血清降钙素原(PCT)、白三烯B4(LTB4)的影响。方法选取480例呼吸道细菌感染患者作为研究对象,按照患者入院诊疗顺序编号,用信封法将其分为观察组和对照组,每组240例,所有患者均采取哌拉西林钠他唑巴坦钠治疗,观察组患者在此基础上联合阿奇霉素进行治疗,2组均治疗7 d。比较2组患者的治疗效果、临床指标、PCT、LTB4水平、炎性指标以及不良反应。结果观察组患者的治疗效果(95.83%)显著优于对照组(82.50%)(χ^(2)=22.081,P=0.000);观察组患者的细菌消失率(90.83%)显著高于对照组(77.08%)(χ^(2)=21.041,P=0.000);观察组患者达到进步的平均时间(t=21.019,P=0.000)、达到有效的平均时间(t=5.094,P=0.000)、平均住院时间(t=9.537,P=0.000)均显著短于对照组;治疗后,2组患者的血清PCT、LTB4水平均显著下降,且观察组患者的血清PCT(t=45.160,P=0.000)、LTB4(t=29.583,P=0.000)水平显著低于对照组;2组患者的白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)以及白细胞介素-6(IL-6)均显著下降,且观察组患者的IL-1β(t=32.963,P=0.000)、TNF-α(t=7.293,P=0.001)及IL-6(t=4.950,P=0.021)水平均显著低于对照组;2组患者腹痛、静脉炎以及皮疹比较差异无统计学意义(P>0.05)。结论小儿呼吸道细菌感染采用哌拉西林钠他唑巴坦钠联合阿奇霉素治疗效果优于单独治疗。

Objective To study the curative effect of piperacillin sodium and tazobacta sodium combined with azithromycin on children with respiratory tract bacterial infection and its influence on serum procalcitonin(PCT)and leukotriene B4(LTB4).Methods In this prospective study,480 patients with respiratory tract bacterial infection were selected as the research objects.According to the diagnosis and treatment number of patients after admission,the above patients were divided into observation group and control group by envelope method,with 240 cases in each group.All patients were treated with piperacillin sodium and tazobacta sodium,and the patients in observation group were treated by addtional azithromycin.The both groups were treated for 7 days.The therapeutic effect,clinical indexes,serum PCT and LTB4 levels,inflammatory indexes and adverse reactions were compared between the 2 groups.Results The treatment effect of the observation group(95.83%)was significantly better than that of the control group(82.50%,χ~2=22.081,P=0.000).The bacterial disappearance rate of the observation group(90.83%)was significantly higher than that of the control group(77.08%,χ~2=21.041,P=0.000).The average times of progress(t=21.019,P=0.000),reaching to effectiveness(t=5.094,P=0.000)and hospital stay(t=9.537,P=0.000)of the observation group were significantly shorter than that of the control group.After treatment,the levels of serum PCT and LTB4 in the both groups were significantly decreased,and the levels of serum PCT(t=45.160,P=0.000)and LTB4(t=29.583,P=0.000)in the observation group were significantly lower than those in the control group.After treatment,the interleukin-1β(IL-1β),tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)levels in both groups were significantly decreased,and the IL-1β(t=32.963,P=0.000),TNF-α(t=7.293,P=0.001)and IL-6(t=4.950,P=0.021)of the observation group were significantly lower than those of the control group.There was no significant difference in abdominal pain,phlebitis and rash between the 2 groups(P>0.05).Conclusion The effect of piperacillin sodium and tazobacta sodium combined with azithromycin was better than that of single treatment for bacterial respiratory tract infection in children.