依替米星联合哌拉西林/他唑巴坦治疗急性心肌梗死PCI后肺部感染的临床疗效

Clinical effect of etimicin combined with piperacillin-tazobactam on treatment of acute myocardial infarction patients with pulmonary infection after PCI

目的 探究依替米星联合哌拉西林/他唑巴坦治疗急性心肌梗死患者经皮冠状动脉介入治疗(PCI)后肺部感染的临床疗效。方法 选取2012年1月-2016年12月医院收治的400例PCI急性心肌梗死合并肺部感染患者作为研究对象,按照随机数字表法分为对照组和研究组,每组200例。对照组患者采用静脉注射硫酸依替米星治疗,研究组患者在对照组治疗的基础上加用哌拉西林/他唑巴坦治疗。分析两组患者病原菌感染情况;比较两组患者临床治疗效果、临床症状好转时间及住院时间;测定两组患者治疗前后血清中谷草转氨酶(AST)、肌酸激酶(CK)、乳酸脱氢酶(LDH)、肌酸激酶同工酶(CKMB)、D-二聚体及炎症因子肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)及白介素-8(IL-8)的含量。结果 对照组患者共检出病原菌217株,研究组检出病原菌221株,两组比较差异无统计学意义(χ2=0.692,P=0.405);研究组患者疗效率高于对照组,(Z=4.188,P<0.001);研究组患者体温恢复时间、咳嗽消失时间、肺部啰音消失时间、白细胞恢复时间及住院时间均比对照组缩短(P<0.05);治疗后两组患者血清心肌酶、炎症因子指标及D-二聚体含量均降低,且研究组患者降低幅度较大(P<0.05)。结论 依替米星联合哌拉西林/他唑巴坦治疗急性心肌梗死患者经皮冠状动脉介入治疗后肺部感染具有较好的临床效果,能够改善临床症状并降低血浆D-二聚体、心肌酶指标及血清炎症因子水平。

OBJECTIVE To explore the clinical effect of etimicin combined with piperacillin-tazobactam on treatment of acute myocardial infarction patients with pulmonary infection after PCI.METHODS A total of 400acute myocardial infarction patients complicated with pulmonary infection who received percutaneous coronary intervention (PCI)in the hospital from Jan 2012to Dec 2016were recruited as the study objects and randomly divided into the control group and the study group,with 200cases in each group.The control group was treated with intravenous injection of etimicin sulfate,while the study group was treated with additional piperacillin-tazobactam on basis of the treatment of the control group.The prevalence of infection was analyzed;the clinical curative effect,time of improvement of clinical symptoms and length of hospital stay were compared between the two groups of patients;the levels of serum aspartate aminotransferase(AST),creatine kinase(CK),lactate dehydrogenase(LDH),creatine kinase isoenzyme(CKMB)and D-dimer as well as the levels of inflammatory factors tumor necrosis factor-α (TNF-α),interleukin-6(IL-6)and interleukin-8(IL-8)were determined before and after the treatment.RESULTS Totally 217strains of pathogens were isolated from the control group,221from the study group,and there was no significant difference(χ2=0.692,P=0.405).The effective rate of treatment of the study group was significantly higher than that of the control group(Z=4.188,P<0.001).The time of recovery of body temperature,time of disappearance of cough,time of disappearance of pulmonary rales,time of recovery of white blood cells and length of hospital stay were significantly shorter in the study group than in the control group(P<0.05).The levels of serum myocardial enzymes,inflammatory factors and D-dimer of the two groups of patients were reduced after the treatment,and the levels of the above indexes were reduced more significantly in the study group than in the control group(P<0.05).CONCLUSIONEtimicin combined with piperacillin-tazobactam can achieve remarkable clinical effect on treatment of the acute myocardial infarction patients with pulmonary infection after PCI,improve the clinical symptoms and reduce the levels of plasma D-dimer,myocardial enzymes and serum inflammatory factors.