莫西沙星注射液联合吸入性乙酰半胱氨酸治疗重症肺炎患者的临床研究

Clinical trial of moxifloxacin injection combined with inhaled acetylcysteine in the treatment of patients with severe pneumonia

目的观察莫西沙星注射液联合吸入性乙酰半胱氨酸治疗重症肺炎的临床疗效及安全性。方法将重症肺炎患者随机分为对照组和试验组。对照组患者给予呼吸机辅助;盐酸氨溴索溶液(15 mg/2 mL,qd),静脉滴注;盐酸莫西沙星溶液(0.4 g/250 mL,qd)静脉滴注。试验组在对照组治疗的基础上给予吸入性乙酰半胱氨酸溶液每次3 mL,qd。2组患者均连续治疗1周。比较2组患者的临床疗效和血清指标、呼吸力学指标,以及药物不良反应的发生情况。结果对照组和试验组各30例纳入分析。治疗后,试验组和对照组的总有效率分别为90.00%和66.67%,差异有统计学意义(P<0.05)。治疗后,试验组和对照组的白细胞介素-8分别为(30.15±5.73)和(38.77±7.13)ng·L^(-1),胰岛样素生长因子-Ⅱ分别为(0.49±0.07)和(0.56±0.11)ng·mL^(-1),血清白三烯分别为(43.53±9.38)和(62.75±10.37)ng·L^(-1),中性粒细胞水平分别为(52.31±11.73)%和(68.77±13.13)%,自然杀伤细胞水平分别为(4.49±0.81)%和(5.56±1.21)%,CD3^(+)T细胞水平分别为(45.26±3.25)%和(52.37±8.87)%,退烧时长分别为(3.39±1.01)和(8.25±1.37)d,机械通气时间分别为(8.21±1.17)和(10.25±1.38)d,重症监护病房住院时长分别为(10.28±2.17)和(19.75±3.46)d,差异均有统计学意义(均P<0.05)。试验组的总药物不良反应发生率(10.00%)略高于对照组(6.67%),差异无统计学意义(P>0.05)。结论莫西沙星注射液联合吸入性乙酰半胱氨酸治疗重症肺炎的临床疗效更显著,可明显减轻患者炎症反应,改善肺功能,且安全可靠。

Objective To observe the clinical efficacy of moxifloxacin injection combined with inhaled acetylcysteine in the treatment of patients severe pneumonia.Methods Patients with severe pneumonia were randomly divided into control group and treatment group.The patients in control group were given ventilator assistance,intravenous infusion of ambroxol hydrochloride solution(15 mg/2 mL,qd)and intravenous infusion of moxifloxacin hydrochloride solution(0.4 g/250 mL,qd).On the basis of control group,treatment group was inhaled acetylcysteine solution(3 mL per time,qd),and the two groups were treated continuously for 1 week.The clinical efficacy,serum indexes,respiratory mechanics indexes,and adverse drug reactions were compared between the two groups.Results There were 30 cases in control group and 30 cases in treatment group.After treatment,the total effective rates of treatment group and control group were90.00%and 66.67%,with statistical significance(P<0.05).After treatment,the interleukin-8 in treatment groupand control group were(30.15±5.73)and(38.77±7.13)ng·L^(-1);islet like growth factor-Ⅱwere(0.49±0.07)and(0.56±0.11)ng·mL^(-1);serum leukotriene were(43.53±9.38)and(62.75±10.37)ng·L^(-1);neutrophil levels were(52.31±11.73)%and(68.77±13.13)%;natural killer cell levels were(4.49±0.81)%and(5.56±1.21)%;CD3^(+)T cell levels were(45.26±3.25)%and(52.37±8.87)%;feverreduction time were(3.39±1.01)and(8.25±1.37)d,mechanical ventilation time were(8.21±1.17)and(10.25±1.38)d;the length of stay in intensive care unit were(10.28±2.17)and(19.75±3.46)d;thedifferences were all statistically significant(all P<0.05).The total incidences of adverse drug reactions in treatmentgroup(10.00%)was slightly higher than that in control group(6.67%,P>0.05).Conclusion Moxifloxacininjection combined with inhaled acetylcysteine has more significant clinical efficacy in the treatment of severepneumonia,can significantly reduce the inflammatory response of patients,improve lung function,is safe and reliable.