两种不同抗菌药物治疗非重症老年医院获得性肺炎的临床研究

Clinical effect of two different antibacterial drugs in the treatment of the non-severe elderly with hospital-acquired pneumonia

目的对比哌拉西林钠他唑巴坦钠、头孢哌酮钠舒巴坦钠治疗非重症老年医院获得性肺炎(hopspital acquired pneumonia,HAP)临床疗效。方法选取北京市第一中西医结合医院2019年8月至2021年10月196例HAP患者,随机分为A组与B组,每组各98例患者,A组给予哌拉西林钠他唑巴坦钠治疗,B组给予头孢哌酮钠舒巴坦钠治疗,比较两组临床治疗效果。结果两组临床治疗有效率分别为80.61%、77.55%、细菌清除率分别为89.57%、88.03%,两组比较未见差异(P>0.05);两组咳嗽消失时间、退热时间、肺部啰音消失时间、肺部阴影消散时间比较均未见差异(P>0.05);两组治疗后血清炎性指标白介素-6、白介素-8、肿瘤坏死因子α、超敏C反应蛋白水平比较均未见差异(P>0.05);两组不良反应发生率比较未见差异(P>0.05);A组成本最低,B组与A组比较每增加1个单位的总有效率,费用增加105.16元。结论哌拉西林钠他唑巴坦钠与头孢哌酮钠舒巴坦钠治疗非重症老年HAP临床疗效未见差异,前者成本效果比较低。

Objective To compare the clinical effect of piperacillin/tazobactam sodium and cefoperazone/sulbactam in the treatment of the non-severe elderly with hospital-acquired pneumonia (HAP).Methods A total of 196 patients with HAP in Beijing First Hospital of Integrated Chinese and Western Medicine were enrolled between August 2019 and October 2021.They were randomly divided into group A and group B,98 cases in each group.Group A was treated with piperacillin/tazobactam sodium,while group B was treated with cefoperazone/sulbactam.The clinical curative effect was compared between the two groups.Results There was no significant difference in response rate of clinical treatment or bacterial clearance rate between the two groups (80.61% vs 77.55%;89.57% vs 88.03%) (P>0.05).There was no significant difference in disappearance time of cough,antipyretic time,disappearance time of lung rales and fade time of lung shadow between the two groups (P>0.05).There was no significant difference in levels of interleukin 6,interleukin 8,tumor necrosis factor α and high sensitivity C-reactive protein between the two groups after treatment (P>0.05).There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05).The treatment cost was relatively lower in group A.Compared with group A,there was one unit increase of total response rate while there was a increase of 105.16 yuan treatment cost in group B.Conclusion There is no difference in the clinical curative effect of piperacillin/tazobactam sodium and cefoperazone/sulbactam on the elderly with non-severe HAP.However,cost-effectiveness ratio of piperacillin/tazobactam sodium is lower.