纤维支气管镜下局部注射乙酰半胱氨酸联合美罗培南治疗重症肺炎的效果及对氧化应激指标、sTREM-1、sICAM-1水平的影响

Effect of local injection of acetylcysteine under fiberoptic bronchoscopy combined with meropenem in the treatment of severe pneumonia and its influences on oxidative stress indexes,sTREM-1 and sICAM-1 levels

目的探讨纤维支气管镜下局部注射乙酰半胱氨酸联合美罗培南治疗重症肺炎的效果及对氧化应激指标、可溶性髓样细胞触发受体-1(sTREM-1)、可溶性细胞间黏附分子-1(sICAM-1)水平的影响。方法选取2020年1月至2021年10月我院接收的98例重症肺炎患者为研究对象,根据治疗方案将其分为对照组和观察组,各49例。对照组给予美罗培南治疗,观察组在对照组基础上给予纤维支气管镜下局部注射乙酰半胱氨酸治疗。比较两组的治疗效果。结果治疗后,两组的动脉血氧分压(PaO_(2))、血氧饱和度(SaO_(2))、氧合指数(OI)均升高,且观察组高于对照组(P<0.05)。治疗后,两组的丙二醛(MDA)水平均降低,谷胱甘肽过氧化物酶(GSH-Px)、超氧化物歧化酶(SOD)水平均升高,且观察组优于对照组(P<0.05)。治疗后,两组的sTREM-1、sICAM-1水平均降低,且观察组低于对照组(P<0.05)。结论纤维支气管镜下局部注射乙酰半胱氨酸联合美罗培南可减轻重症肺炎患者的氧化应激反应,调节sTREM-1、sICAM-1水平,促进肺功能恢复。

Objective To explore the effect of local injection of acetylcysteine under fiberoptic bronchoscopy combined with meropenem in the treatment of severe pneumonia and its influences on oxidative stress indexes,soluble triggering receptor expressed on myeloid cells-1(sTREM-1)and soluble intercellular adhesion molecule-1(sICAM-1)levels.Methods A total of 98 patients with severe pneumonia received in our hospital from January 2020 to October 2021 were selected as the research objects.According to the treatment plan,the patients were divided into control group and observation group,with 49 cases in each group.The control group was treated with meropenem,and the observation group was treated with local injection of acetylcysteine under fiberoptic bronchoscopy on the basis of the control group.The therapeutic effects of the two groups were compared.Results After treatment,the arterial partial pressure of oxygen(PaO_(2)),blood oxygen saturation(SaO_(2))and oxygenation index(OI)in the two groups increased,and those in the observation group were higher than the control group(P<0.05).After treatment,the level of malondialdehyde(MDA)in the two groups decreased,the levels of glutathione peroxidase(GSH-Px)and superoxide dismutase(SOD)increased,and those in the observation group were better than the control group(P<0.05).After treatment,the levels of sTREM-1 and sICAM-1 in the two groups decreased,and those in the observation group were lower than the control group(P<0.05).Conclusion Local injection of acetylcysteine under fiberoptic bronchoscopy combined with meropenem can reduce oxidative stress,regulate the levels of sTREM-1 and sICAM-1,and promote the recovery of lung function in patients with severe pneumonia.