美罗培南联合莫西沙星治疗慢性阻塞性肺疾病合并感染性肺炎的临床疗效及安全性

Clinical efficacy and safety of meropenem combined with moxifloxacin on pulmonary function and inflammatory factors in patients with chronic obstructive pulmonary disease complicated with infectious pneumonia

目的探讨美罗培南联合莫西沙星治疗慢性阻塞性肺疾病(COPD)合并感染性肺炎的临床疗效及安全性。方法选取2020年1月至2021年12月内蒙古林业总医院收治的88例COPD合并感染性肺炎患者作为研究对象,按照随机数字表法分为观察组与对照组,每组44例。两组均接受COPD基础治疗,对照组静脉滴注莫西沙星治疗,观察组在对照组基础上给予美罗培南治疗,比较两组临床疗效、症状及体征改善时间、肺功能指标[最大呼气中期流速(MMEF)、第1秒用力呼气容积占预计值百分比(FEV_(1)%)、最大自主通气量占预计值百分比(MVV%)]、炎症因子[超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)及降钙素原(PCT)]及不良反应发生情况。结果观察组治疗总有效率高于对照组,差异有统计学意义(P<0.05)。观察组肺湿啰音、咳嗽、呼吸困难、体温及白细胞改善时间均短于对照组,差异有统计学意义(P<0.05)。治疗后,两组MMEF均快于治疗前,FEV_(1)%、MVV%均高于治疗前,且观察组MMEF快于对照组,FEV_(1)%、MVV%均高于对照组,差异有统计学意义(P<0.05)。治疗后,两组hs-CRP、TNF-α、IL-6及PCT水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义。结论美罗培南联合莫西沙星治疗COPD合并感染性肺炎效果显著,可减轻肺部炎症损伤,加快症状及体征消失,增强肺功能,安全性高,值得临床推广应用。

Objective To investigate the clinical efficacy and safety of meropenem combined with moxifloxacin in the treatment of chronic obstructive pulmonary disease complicated with infectious pneumonia.Methods A total of 88 patients with COPD complicated with infectious pneumonia who were admitted to Inner Mongolia Forestry General Hospital from January 2020 to December 2021 were selected as the research subjects,and they were divided into the observation group and the control group according to the random number table method,with 44 cases in each group.Both groups received basic COPD therapy,the control group received intravenous moxifloxacin therapy,and the observation group received meropenem therapy on the basic of control group.The clinical efficacy,improvement time of symptoms and signs,pulmonary function indexes(maximum mid-expiratory flow[MMEF],forced expiratory volume in one second%[FEV_(1)%],maximalvoluntaryventilation%[MVV%]),inflammatory factors(hypersensitive C-reactive protein[hs-CRP],tumor necrosis factor-α[TNF-α],interleukin-6[IL-6]and procalcitonin[PCT])and the occurrence of adverse reactions were compared between the two groups.Results The total effective rate in the observation group was higher than that in the control group,the difference was statistically significant(P<0.05).The improvement time of lung moist rales,cough,dyspnea,body temperature and white blood cells in the observation group were shorter than those in control group,the differences were statistically significant(P<0.05).After treatment,MMEF of the two groups was faster than that before treatment,FEV_(1)%and MVV%were higher than those before treatment,and MMEF in the observation group was faster than that in the control group,FEV_(1)%and MVV%were higher than the control group,the differences were statistically significant(P<0.05).After treatment,the levels of hs-CRP,TNF-α,IL-6 and PCT of the two groups were lower than before treatment,and observation group was lower than the control group,the differences were statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups.Conclusion Meropenem combined with moxifloxacin is effective in the treatment of COPD complicated with infectious pneumonia,which reduce pulmonary inflammatory injury,accelerate the disappearance of symptoms and signs,and enhance lung function,which is safe and worthy of clinical promotion and application.