哌拉西林-他唑巴坦对急性心肌梗死经皮冠状动脉介入治疗术后医院感染者炎性因子的影响

Influence of piperacillin-tazobactam on inflammatory factors in patients with acute myocardial infarction after percutaneous coronary intervention

目的 探究哌拉西林-他唑巴坦对急性心肌梗死经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)术后医院感染患者炎性因子及心肌酶谱的影响。方法 以80例急性心肌梗死PCI术后医院感染患者作为研究对象,随机分为对照组和观察组,每组40例。对照组给予头孢呋辛,观察组给予哌拉西林-他唑巴坦。比较2组的临床疗效、炎性因子[超敏C反应蛋白(high-sensitivity C-reactive protein,hs-CRP)、基质金属蛋白酶-9(matrix metalloproteinase-9,MMP-9)和白细胞介素-6(interleukin-6,IL-6)]、左心室重构[左心室舒张末期内径(left ventricular end-systolic diameter, LVESD)、收缩末期内径(left ventricular end-diastolic diameter, LVEDD)和左心室射血分数(left ventricular ejection fraction, LVEF)]、心肌酶谱指标[肌钙蛋白Ⅰ(cardiac troponin Ⅰ,cTnⅠ)、肌酸激酶同工酶(creatine kinase-MB, CK-MB)和肌酸脱氢酶(lactate dehydrogenase, LDH)]和不良反应。结果 治疗后,与对照组比较,观察组的总有效率明显较高(P<0.05);观察组的hs-CRP、MMP-9和IL-6均明显较低(P<0.05),LVESD、LVEDD均明显较低(P<0.05), LVEF明显较高(P<0.05), cTnⅠ、CK-MB和LDH均明显较低(P<0.05);2组不良反应总发生率比较差异无统计学意义(P>0.05)。结论 哌拉西林-他唑巴坦对急性心肌梗死PCI术后医院感染患者具有较好的临床疗效,可下调炎性因子,减轻左心室重构,降低心肌酶谱指标水平,且安全性高。

Objective To investigate the effect of piperacillin-tazobactam treatment on inflammatory factors and myocardial enzyme spectrum in patients with acute myocardial infarction after percutaneous coronary intervention(PCI)with nosocomial infection.Methods 80 cases of acute myocardial infarction patients with nosocomial infection after PCI were enrolled and randomly divided into control group and observation group,40 cases in each group.The control group was given cefuroxime,while the observation group was given piperacillin-tazobactam.The clinical efficacy,inflammatory factors[high-sensitivity C-reactive protein(hs-CRP),matrix metalloproteinase-9(MMP-9),and interleukin-6(IL-6)],left ventricular remodeling[ventricular end-diastolic diameter(LVESD)],end-systolic diameter(LVEDD),and left ventricular ejection fraction(LVEF),myocardial enzymes[troponinⅠ(cTnⅠ),creatine kinase isoenzyme(CK-MB),and creatine dehydrogenase(LDH)]and adverse reactions were compared between the 2 groups.Results Compared with control group,the total effective rate in observation group was significantly higher(P<0.05).After treatment,compared with control group,the hs-CRP,MMP-9,and IL-6,LVESD and LVEDD in observation group were significantly lower(P<0.05),the LVEF was significantly higher(P<0.05),and the cTnⅠ,CK-MB and LDH were significantly lower(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the 2 groups(P>0.05).Conclusion Piperacillin-tazobactam has a good clinical effect in patients with acute myocardial infarction after PCI and nosocomial infection.It can down-regulate inflammatory factors,relieve left ventricular remodeling,and reduce the level of myocardial enzyme spectrum indexes,with good safety.