莫西沙星联合比阿培南治疗老年重症肺炎患者疗效及对炎性因子肿瘤坏死因子相关激活蛋白和血管细胞黏附分子-1的影响

Effects of moxifloxacin combined with biapenem in the treatment of elderly patients with severe pneumo-nia and its influence on inflammatory factors,serum CD40L and VACM-1

目的探讨莫西沙星联合比阿培南治疗老年重症肺炎患者疗效及对炎性因子、血清中肿瘤坏死因子相关激活蛋白(CD40L)和血管细胞黏附分子-1(VACM-1)的影响。方法采用前瞻性分析,选取浙江省人民医院收治的150例老年重症肺炎患者,根据随机数字表法分为2组,各75例。其中采用比阿培南治疗者为对照组,采用莫西沙星联比阿培南治疗者为联合组。比较2组患者疗效、病原菌检出率、炎性因子、血清CD40L和VACM-1水平。结果联合组临床总有效率明显高于对照组(97%与79%),治疗后致病菌检出率低于对照组(χ^(2)=21.714、4.812,P<0.05);联合组肺部体征、咳嗽、气喘消退时间较对照组明显缩短(t=4.751,P=0.018;t=4.369,P=0.023;t=5.134,P=0.007);联合组治疗后血清白细胞介素6(IL-6)、C-反应蛋白(CRP)、降钙素原(PCT)、CD40L和VACM-1水平均低于对照组(t=3.721,P=0.019;t=4.021,P=0.016;t=4.739,P=0.012;t=3.792,P=0.020;t=5.134,P=0.001);联合组与对照组不良反应发生率比较差异无统计学意义(χ^(2)=0.714,P=0.381)。结论莫西沙星联合比阿培南治疗老年重症肺炎患者疗效显著,患者炎症反应明显减轻,血清CD40L、VACM-1表达明显下调,且安全性较高,值得推荐。

Objective To investigate the curative effect of moxifloxacin combined with biapenem in the treatment of elderly patients with severe pneumonia and its influence on sex factors,serum tumor necrosis factor related activating protein(CD40L)and vascular cell adhesion molecule-1(VACM-1).Methods Using a prospective case-control analysis method,a total of 150 elderly patients with severe pneumonia admitted to Zhejiang Provincial People′s Hospital,were selected and randomly divided into two groups,with 75 cases in each group.Among them,those treated with biapenem were taken as the control group,and those treated with moxifloxacin combined with biapenem were taken as the the combinated group.The efficacy,pathogen detection rate,inflammatory factors,serum CD40L and VACM-1 levels were compared between the two groups.Results The total clinical effective rate of the combined group was significantly higher than that of the control group(97%vs 79%),and the detection rate of pathogens after treatment was lower than that of the control group(χ^(2)=21.714,4.812,P<0.05);The regression time of lung signs,cough,and asthma in the combined group were significantly shorter than that in the control group(t=4.751,P=0.018;t=4.369,P=0.023;t=5.134,P=0.007);After treatment,the levels of serum interleukin-6(IL-6),C-reactive protein(CRP),procalcitonin(PCT),CD40L,and VACM-1 in the combined group were lower than those in the control group(t=3.721,P=0.019;t=4.021,P=0.016;t=4.739,P=0.012;t=3.792,P=0.020;t=5.134,P=0.001);There was no significant difference in the incidence of adverse reactions between the combined group and the control group(χ^(2)=0.714,P=0.381).Conclusion The efficacy moxifloxacin combined with biapenem in the treatment of elderly patients with severe pneumonia was significant,the inflammatory reaponse of patients was significantly reduced,the expressions of serum CD40L and VACM-1 were significantly down-regulated,and the safety was high,which was worthy of recommendation.