头孢哌酮钠舒巴坦联合莫西沙星治疗COPD合并急性呼吸道感染的临床疗效及其对炎性反应的影响

Clinical effect of cefoperazone sodium sulbactam combined with moxifloxacin in the treatment of COPD complicated with acute upper respiratory tract infection and the impact on inflammatory reaction

目的观察头孢哌酮钠舒巴坦与莫西沙星联合治疗慢性阻塞性肺疾病(COPD)合并急性呼吸道感染的效果及其对炎性反应的影响。方法选取2019年5月—2021年10月湖口县人民医院收治的COPD合并急性呼吸道感染患者72例,采用随机数字表法分为对照组36例和观察组36例。患者入院后采用常规治疗,在此基础上,对照组患者采用莫西沙星治疗,观察组患者在对照组基础上联合头孢哌酮钠舒巴坦治疗,2组均持续治疗30 d。比较2组临床疗效,治疗前及治疗30 d后炎性因子[肿瘤坏死因子α(TNF-α)、白介素6(IL-6)、超敏C反应蛋白(hs-CRP)]、血气分析指标[血氧饱和度(SaO_(2))、动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))]、免疫功能指标[CD_(4)^(+)/CD_(8)^(+)、免疫球蛋白(Ig)A、IgM、补体C3],不良反应发生率。结果观察组总有效率(91.67%)高于对照组(72.22%)(χ^(2)=4.600,P=0.032)。与治疗前相比,治疗30 d后2组TNF-α、IL-6、hs-CRP水平降低(P<0.01),且观察组低于对照组(P<0.01)。与治疗前相比,治疗30 d后2组SaO_(2)、PaO_(2)升高,PaCO_(2)降低(P<0.01),且观察组升高/降低幅度大于对照组(P<0.01)。与治疗前相比,治疗30 d后2组CD_(4)^(+)/CD_(8)^(+)及IgA、IgM、补体C3水平升高(P<0.01),且观察组均高于对照组(P<0.01)。观察组不良反应总发生率(11.11%)与对照组(27.78%)比较,差异无统计学意义(χ^(2)=3.192,P=0.074)。结论头孢哌酮钠舒巴坦联合莫西沙星治疗COPD合并急性呼吸道感染的临床疗效确切,可更有效地减轻机体炎性反应,改善动脉血气,促进免疫功能恢复,且不会增加药物不良反应,安全性较高。

Objective To discuss the clinical effect of cefoperazone sodium sulbactam combined with moxifloxacin in the treatment of COPD complicated with acute upper respiratory tract infection and the impact on inflammatory reaction.Methods A total of 72 cases of COPD patients complicated with acute upper respiratory tract infection were selected from May 2019 to October 2021 in Hukou County People′s Hospital,and they were divided into control group for 36 cases and observation group for 36 cases.Patients were given conventional therapy,on the basis of this,patients in control group were treated with moxifloxacin,patients in observation group were treated with cefoperazone sodium sulbactam based on control group,both groups were treated for 30 days.Clinical effect,inflammatory factors(TNF-α,IL-6,hs-CRP),blood gas analysis index(SaO_(2),PaO_(2),PaCO_(2)),immune function indexes(CD_(4)^(+)/CD_(8)^(+),IgA,IgM,complement C3)before treatment and at 30 days after treatment,incidence of adverse reactions were compared between the two groups.Results Total effective rate of observation group(91.67%)was higher than control group(72.22%)(χ^(2)=4.600,P=0.032).Compared with those before treatment,levels of TNF-α,IL-6,hs-CRP in the two groups were decreased at 30 days after treatment(P<0.01),and those in observation group were lower than control group at 30 days after treatment(P<0.01).Compared with those before treatment,SaO_(2),PaO_(2)in the two groups were increased,PaCO_(2)was decreased at 30 days after treatment(P<0.01),and SaO_(2),PaO_(2)at 30 days after treatment in observation group were higher than those in control group,PaCO_(2)was lower than that in control group(P<0.01).Compared with those before treatment,CD_(4)^(+)/CD_(8)^(+)and levels of IgA,IgM,complement C3 in the two groups were increased at 30 days after treatment(P<0.01),and those in observation group were higher than control group at 30 days after treatment(P<0.01).There was no significant difference of incidence of adverse reactions between the observation group(11.11%)and control group(27.78%)(χ^(2)=3.192,P=0.074).Conclusion Cefoperazone sodium sulbactam combined with moxifloxacin have an exact clinical effect in the treatment of COPD complicated with acute upper respiratory tract infection,it can more effectively reduce inflammatory reaction,improve blood gas analysis,promote the recovery of immune function,and will not increase adverse drug reactions,with high safety.