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头孢哌酮/舒巴坦联合莫西沙星治疗COPD合并急性下呼吸道感染临床疗效及对血清相关因子的影响
徐敏,胡岗,刘晓,梁宗安
0
(四川大学;成都市第五人民医院呼吸内科;四川大学华西医院呼吸与危重医学科)
摘要:
【摘要】 目的 探讨头孢哌酮/舒巴坦联合莫西沙星治疗COPD合并急性下呼吸道感染临床疗效及对血清PCT和CRP水平的影响。方法 通过对成都市第五人民医院2017年1月~2018年2月就诊收治的198例COPD合并急性下呼吸道感染患者临床资料做回顾性分析,并根据给药方案的不同分为观察组和对照组,每组各99例。对照组给予单一头孢哌酮/舒巴坦治疗,观察组给予头孢哌酮/舒巴坦联合莫西沙星治疗。比较两组治疗疗效、抗菌疗效、不良反应发生情况及治疗前后的PCT、CRP、WBC、IL6、CD8+、CD4+/CD8+、CD3+水平。结果 观察组治疗总有效率高于对照组(χ2=6145,P=0013);治疗后两组血清PCT、CRP、WBC、IL6水平均低于治疗前(P<005),且观察组各炎性指标水平低于对照组(P<005);治疗后两组CD4+/CD8+、CD3+水平均高于治疗前,CD8+水平均低于治疗前(P<005),且观察组CD4+/CD8+、CD3+水平高于对照组,CD8+水平低于对照组(P<005);观察组细菌清除率高于对照组(χ2=4475,P=0034);两组患者不良反应总发生率比较差异无统计学意义(2=0421,P=0516)。结论 头孢哌酮/舒巴坦联合莫西沙星治疗COPD合并急性下呼吸道感染患者临床疗效及抗菌作用显著,可有效地抑制其血清PCT、CRP水平,改善免疫功能,且安全可靠。
关键词:  头孢哌酮/舒巴坦  莫西沙星  COPD合并急性下呼吸道感染  临床疗效  血清PCT  CRP水平
DOI:
基金项目:四川省医学会青年创新项目(Q16008)
Clinical efficacy of cefoperazone/sulbactam combined with moxifloxacin in the treatment of COPD complicated with acute lower respiratory tract infection and its effect on serum PCT and CRP levels
XU Min,HU Gang,LIU Xiao,LIANG Zong’an
(Sichuan University;Department of Respiratory Medicine, The Fifth People's Hospital of Chengdu;Department of Respiratory and Critical Medicine, West China Hospital)
Abstract:
【Abstract】 Objective To investigate the clinical efficacy of cefoperazone/sulbactam combined with moxifloxacin in the treatment of COPD complicated with acute lower respiratory tract infection and the effects of serum PCT and CRP levels.Methods We retrospectively analyzed the clinical data of 198 patients with COPD complicated with acute lower respiratory tract infection admitted to The Fifth People's Hospital of Chengdu hospital from January 2017 to February 2018. According to the different dosing regimens, they were divided into observation group and control group (99 cases each). The control group was given a single cefoperazone/sulbactam treatment and the observation group was given cefoperazone/sulbactam combined with moxifloxacin. After a single cefoperazone/sulbactam treatment, the observation group was treated with cefoperazone/sulbactam and moxifloxacin. The therapeutic efficacy, antibacterial efficacy, incidence of adverse reactions, and levels of PCT, CRP, WBC, IL6, CD8+, CD4+/CD8+, and CD3+ before and after treatment were compared between the two groups of patients. Results The total effective rate of treatment in the observation group (8990%) was higher than that of the control group (7677%) (P=0013). After treatment, serum PCT, CRP, WBC, and IL6 levels in both groups were lower than before treatment (P<005). The level of each inflammatory index in the observation group was lower than that in the control group (P<005). After treatment, the levels of CD4+/CD8+ and CD3+ in both groups were higher than before treatment, and the levels of CD8+ were lower than before treatment (P<005). The level of CD4+/CD8+ and CD3+ in the observation group was higher than that in the control group, and the level of CD8+ was lower in the observation group than in the control group (P<005). The bacterial clearance rate of the observation group (9358%) was higher than that of the control group (8468%) (χ2=4475, P=0034). There was no significant difference between the two groups in the total incidence of adverse reactions [(606%)VS (404%)](χ2=0421, P=0516).Conclusion Cefoperazone/sulbactam combined with moxifloxacin has significant clinical efficacy and antibacterial effect on patients with COPD complicated with acute lower respiratory tract infection. It can effectively inhibit serum PCT and CRP levels and improve immune function, and it is safe and reliable.
Key words:  Cefoperazone/sulbactam  Moxifloxacin  COPD with acute lower respiratory tract infection  Clinical efficacy  Serum PCT  Serum CRP

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