哌拉西林他唑巴坦治疗急性加重期慢性阻塞性肺疾病的疗效及对患者血气指标与炎症因子水平的影响

Effect of piperacillin-tazobactam in the treatment of acute exacerbation of chronic obstructive pulmonary disease and its influences on blood gas index and levels of inflammatory factors

目的探讨哌拉西林他唑巴坦治疗急性加重期慢性阻塞性肺疾病(慢阻肺)的疗效及对患者血气指标、炎症因子水平的影响。方法选取2019年1月至2021年1月于萍乡市第三人民医院确诊的60例急性加重期慢阻肺患者作为研究对象,随机分为观察组与对照组,每组30例。对照组给予头孢噻肟治疗,观察组给予哌拉西林他唑巴坦治疗,比较两组临床疗效、治疗前后血气指标[动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、血氧饱和度(SaO_(2))]、炎症因子水平[C反应蛋白(CRP)、WBC、中性粒细胞(N)]及不良反应发生情况。结果观察组治疗总有效率为93.33%,高于对照组的73.33%,差异有统计学意义(P<0.05)。治疗前,两组PaO_(2)、PaCO_(2)、SaO_(2)比较差异无统计学意义;治疗后,两组PaO_(2)、SaO_(2)均高于治疗前,PaCO_(2)均低于治疗前,且观察组PaO_(2)、SaO_(2)均高于对照组,PaCO_(2)低于对照组,差异有统计学意义(P<0.05)。治疗前,两组WBC及N、CRP水平比较差异无统计学意义;治疗后,两组WBC均小于治疗前,N、CRP水平均低于治疗前,且观察组WBC小于对照组,N、CRP水平均低于对照组,差异有统计学意义(P<0.05)。观察组不良反应发生率为20.00%,低于对照组的46.67%,差异有统计学意义(P<0.05)。结论哌拉西林他唑巴坦治疗急性加重期慢阻肺疗效确切,可改善患者血气指标,降低患者体内炎症因子水平,值得临床推广应用。

Objective To investigate the efficacy of piperacillin-tazobactam in the treatment of acute exacerbation chronic obstructive pulmonary disease(COPD)and the effects on blood gas index and inflammatory factors.Methods 60 patients with acute exacerbation COPD diagnosed in the Third People's Hospital of Pingxiang City from January 2019 to January 2021 were selected as research subjects,and they were randomly divided in-to the observation group and the control group,with 30 cases in each group.The control group was treated with cefotaxime,the observation group was treated with piperacillin-tazobactam,the clinical efficacy,blood gas indexes(arterial oxygen partial pressure[PaO_(2)],arterial blood carbon diox-ide partial pressure[PaCO_(2)],arterial oxygen saturation[SaO_(2)]),inflammatory factor levels(C-reactive protein[CRP],WBC,neutrophil[N])and be-fore and after treatment,adverse reactions were compared between the two groups.Results The total effective rate in the observation group was 93.33%,which was higher than 73.33%in the control group,the difference was statistically significant(P<0.05).Before treatment,there were no significant differences in PaO_(2),PaCO_(2)and SaO_(2)between the two groups;after treatment,PaO_(2)and SaO_(2)of the two groups were higher than before treatment,and PaCO_(2)were lower than before treatment,and PaO_(2)and SaO_(2)in the observation group were higher than the control group,PaCO_(2)was lower than the control group,the differences were statistically significant(P<0.05).Before treatment,there was no significant difference in WBC,N and CRP levels between the two groups;after treatment,WBC of the two groups was lower than before treatment,and the levels of N and CRP were lower than before treatment;WBC in the observation group was lower than that in the control group,and the levels of N and CRP were lower than the control group,the differences were statistically significant(P<0.05).The incidence of adverse reactions in the observation group was 20.00%,which was lower than 46.67%in the control group,the difference was statistically significant(P<0.05).Conclusion Piperacillin-tazobactam were effective in the treatment of COPD in acute exacerbation,which could improve blood gas indexes and reduce the level of inflammatory factors in pa-tients,and was worthy of clinical promotion and application.