支气管镜联合替加环素对老年重症肺炎患者的疗效及对免疫功能的影响

Efficacy of bronchoscope combined with tigecycline on elderly patients with severe pneumonia and its influence on immune function

目的研究支气管镜联合替加环素对老年重症肺炎患者的疗效及对免疫功能的影响。方法选取2017年6月至2019年6月就诊的老年重症肺炎患者86例,按照随机数字法分为支气管镜组和联合组,每组43例。2组患者均给予纤维支气管镜灌洗治疗,支气管镜组给予头孢哌酮舒巴坦治疗,联合组在支气管镜组的基础上给予替加环素治疗,检测免疫功能、肺功能、STREM-1、CRP、HMGB-1水平,统计治疗有效率、并发症发生率。结果2组患者治疗后CD4^(+)、CD8^(+)、CD3^(+)、CD4^(+)/CD8^(+)、PEF、FVC、MMEF、FEV1高于治疗前,STREM-1、CRP、HMGB-1水平低于治疗前,差异有统计学意义(P<0.05)。联合组CD4^(+)、CD8^(+)、CD3^(+)、CD4^(+)/CD8^(+)、PEF、FVC、MMEF、FEV1指标水平高于支气管镜组,STREM-1、CRP、HMGB-1水平低于治疗前,差异有统计学意义(P<0.05)。联合组治疗有效率为93.02%高于支气管镜组76.74%(P<0.05)。联合组并发症发生率为16.28%支气管镜组为20.93%,差异无统计学意义(P>0.05)。结论支气管镜联合替加环素对老年重症肺炎患者治疗效果显著,能有效的提高患者免疫功能,促进肺功能改善,降低炎性反应,提高治疗效率。

Objective To study the efficacy of bronchoscope combined with tigecycline on elderly patients with severe pneumonia and its influence on immune function.Methods A total of 86 elderly patients with severe pneumonia treated in our hospital from June 2017 to June 2019 were randomly assigned to the bronchoscope group(n=43)and the combination group(n=43).All patients were managed by fiberoptic bronchoscopy lavage,and the bronchoscope group received cefoperazone and sulbactam,and the combination group received tigecycline based on the bronchoscope group.The aim was to detect soluble triggering receptor expressed on myeloid cells-1(sTREM-1),C-reactive protein(CRP),high mobility group box-1(HMGB-1).The treatment efficiency and the incidence of complications were assessed.Results After treatment,CD4^(+),CD8^(+),CD3^(+),CD4^(+)/CD8^(+),peak expiratory flow(PEF),forced vital capacity(FVC),maximal mid-expiratory flow(MMEF),forced expiratory volume in one second(FEV1)in groups were significantly increased,while STREM-1,CRP,HMGB-1 were significantly decreased(P<0.05).Significantly increased CD4^(+),CD8^(+),CD3^(+),CD4^(+)/CD8^(+),PEF,FVC,MMEF,FEV1,and decreased STREM-1,CRP,HMGB-1 were detected in the combination group(P<0.05).The treatment efficiency was 93.02%in the combination group,higher than that of 76.74%in the bronchoscope group(P<0.05).The difference was not statistically significant in the incidence of complications between the combination group and the bronchoscope group(16.28%vs 20.93%,P>0.05).Conclusion For elderly patients with severe pneumonia,bronchoscope combined with tigecycline has a significant effect,can effectively improve immune function and lung function,reduce inflammatory response,and improve treatment efficiency.