亚胺培南联合美罗培南对肺癌合并重症肺部感染患者的治疗效果

Therapeutic effect of imipenem combined with meropenem in lung cancer patients with severe pulmonary infection

目的探讨亚胺培南联合美罗培南对肺癌合并重症肺部感染患者的治疗效果。方法根据治疗方式的不同将80例肺癌合并重症肺部感染患者分为亚胺培南组(n=39,亚胺培南治疗)和联合组(n=41,亚胺培南联合美罗培南治疗)。比较两组患者的临床疗效、病原菌清除率、肝肾功能指标[血尿素氮(BUN)、血清肌酐(Scr)、丙氨酸转氨酶(ALT)]及炎性因子[肿瘤坏死因子-α(TNF-α)、降钙素原(PCT)、白细胞介素-6(IL-6)]水平。结果联合组患者的总有效率和病原菌清除率均高于亚胺培南组,差异均有统计学意义(P﹤0.05)。治疗后,两组患者ALT、BUN、Scr水平均高于本组治疗前,差异均有统计学意义(P﹤0.05);治疗后,两组患者ALT、BUN、Scr水平比较,差异均无统计学意义(P﹥0.05)。治疗后,两组患者TNF-α、PCT、IL-6水平均低于本组治疗前,联合组患者TNF-α、PCT、IL-6水平均低于亚胺培南组,差异均有统计学意义(P﹤0.05)。结论亚胺培南联合美罗培南治疗肺癌合并重症肺部感染患者可提高临床疗效和病原菌清除率,减轻炎症反应,且不会加重肝肾功能损伤。

Objective To investigate the therapeutic effect of imipenem combined with meropenem in lung cancer patients with severe pulmonary infection.Method A total of 80 patients with lung cancer complicated with severe pulmonary infection were divided into the imipenem group(n=39,treated with imipenem)and the combination group(n=41,treated with imipenem and meropenem)according to different treatment methods.The clinical efficacy,pathogen clearance rate,liver and kidney function indicators[blood urea nitrogen(BUN),serum creatinine(Scr),alanine aminotransferase(ALT)],and inflammatory factors[tumor necrosis factor-α(TNF-α),procalcitonin(PCT),interleukin-6(IL-6)]levels were compared between the two groups.Result The total effective rate and pathogen clearance rate of the combination group were higher than those of the imipenem group,and the differences were statistically significant(P<0.05).After the treatment,the levels of ALT,BUN,and Scr in both groups were higher than those before the treatment,and the differences were statistically significant(P<0.05).After the treatment,there were no statistically significant differences in the levels of ALT,BUN,and Scr between the two groups(P>0.05).After the treatment,the levels of TNF-α,PCT,and IL-6 in both groups were lower than those before the treatment,and the levels of TNF-α,PCT,and IL-6 in the combination group were lower than those in the imipenem group,and the differences were statistically significant(P<0.05).Conclusion The combination of imipenem and meropenem could improve the clinical efficacy and pathogen clearance rate of patients with lung cancer complicated with severe pulmonary infection,and reduce the inflammatory response without aggravating liver and kidney function damage.