利奈唑胺联合多黏菌素B、亚胺培南治疗老年MDR-AB肺炎患者的效果

Effects of Linezolid combined with Polymyxin B and Imipenem in treatment of elderly patients with MDR-AB pneumonia

目的:观察利奈唑胺联合多黏菌素B、亚胺培南治疗老年多重耐药鲍氏不动杆菌(MDR-AB)肺炎患者的效果。方法:选取2022年1月至2023年1月该院收治的120例老年MDR-AB肺炎患者进行前瞻性研究,按照随机数字表法分为观察组与对照组各60例。对照组采用多黏菌素B联合亚胺培南治疗,观察组在对照组基础上加用利奈唑胺葡萄糖注射液治疗,比较两组治疗总有效率、血清炎性因子[白细胞介素(IL)-6、IL-8、肿瘤坏死因子(TNF-α)]水平、外周血T细胞亚群指标(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))水平、肺功能指标[用力肺活量(FVC)、最大呼气中段流量(MMF)、呼气峰流速(PEF)]水平和不良反应发生率。结果:观察组治疗总有效率为95.00%,明显高于对照组的83.33%,差异有统计学意义(P<0.05);治疗后,观察组FVC、MMF、PEF、CD3^(+)、CD4^(+)和CD4^(+)/CD8^(+)水平高于对照组,IL-6、IL-8、TNF-α和CD8^(+)水平低于对照组,差异均有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:利奈唑胺联合多黏菌素B、亚胺培南治疗老年MDR-AB肺炎患者可提高治疗总有效率和肺功能指标水平,改善T细胞亚群指标水平,以及降低炎性因子水平,效果优于多黏菌素B联合亚胺培南治疗。

Objective:To observe effects of Linezolid combined with Polymyxin B and Imipenem in treatment of elderly patients with multidrug-resistant Acinetobacter baumannii(MDR-AB)pneumonia.Methods:A prospective study was conducted on 120 elderly patients with MDR-AB pneumonia admitted to this hospital from January 2022 to January 2023.According to the random number table method,they were divided into observation group and control group,60 cases in each group.The control group was treated with Polymyxin B combined with Imipenem,while the observation group was treated with Linezolid glucose injection on the basis of those of the control group.The total effective rate of treatment,the serum inflammatory factors[interleukin(IL)-6,IL-8,tumor necrosis factor-α(TNF-α)]levels,the peripheral blood T cell subsets indicators(CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+))levels,the lung function indicators[forced vital capacity(FVC),maximum mid-expiratory flow(MMF),peak expiratory flow(PEF)]levels,and the incidence of adverse reactions were compared between the two groups.Results:The total effective rate of the observation group was 95.00%,which was significantly higher than 83.33%of the control group,and the difference was statistically significant(P<0.05).After the treatment,the levels of FVC,MMF,PEF,CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in the observation group were higher than those in the control group,the levels of IL-6,IL-8,TNF-αand CD8^(+)were lower than those in the control group,and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusions:Linezolid combined with Polymyxin B and Imipenem in the treatment of the elderly patients with MDR-AB pneumonia can improve the total effective rate of treatment and the level of lung function indicators,improve the levels of T cell subsets,and reduce the levels of inflammatory factors.Moreover,it is superior to Polymyxin B combined with Imipenem treatment.