摘要
目的:人免疫球蛋白(HIG)联合亚胺培南西司他丁钠(IMP/CS)和哌拉西林他唑巴坦钠(PS/TS)治疗重症肺部感染的临床疗效。方法:选择2013年3月~2018年7月复旦大学附属华山医院北院收治的重症肺部感染患者99例为研究对象,采用随机数字法分为A组(33例,采用HIG+IMP/CS+PS/TS治疗)、B组(33例,采用IMP/CS+PS/TS治疗)和C组(33例,采用PS/TS治疗),比较三组有效率、炎性因子、T细胞亚群和不良反应。结果:A组临床总有效率为96.97%,高于B组的78.79%,B组高于C组的60.61%(P<0.05)。治疗7 d后,三组C反应蛋白(CRP)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、CD8^+水平较治疗前降低,CD4^+和CD4^+/CD8^+较治疗前升高,差异有统计学意义(P<0.05)。治疗7 d后,A组CRP、IL-6、TNF-α、CD8^+水平低于B组,B组低于C组(P<0.05);治疗7d后,A组CD4^+和CD4^+/CD8^+高于B组,B组高于C组(P<0.05)。三组治疗期间均无药物相关不良反应的发生。结论:HIG联合IMP/CS和PS/TS治疗重症肺部感染患者安全有效,能有效改善患者的炎性反应,调节免疫功能,促进患者恢复。
Objective:To explore the efficacy of human immunoglobulin(HIG)combined with imipenem-cilastatin sodium(IMP/CS)and piperacillin tazobactam sodium(PS/TS)in the treatment of severe pulmonary infection.Methods:99 cases patients with severe pulmonary infection who were admitted to North Hospital of Huashan Hospital Affiliated to Fudan University from March 2013 to July 2018 were selected as the study subjects.They were randomly divided into group A(33 cases,treated with HIG+IMP/CS+PS/TS),group B(33 cases,treated with IMP/CS+PS/TS)and group C(33 cases,treated with PS/TS).The effectiveness,inflammatory factors,T cell subsets and adverse reactions were observed.Results:The total clinical effective rate of group A was 96.97%,which was higher than78.79%of group B,and that in group B was higher than 60.61%of group C(P<0.05).7 days after treatment,the levels of C-reactive protein(CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and CD8^+in the three groups were lower than those before treatment,the CD4^+and CD4^+/CD8^+were higher than those before treatment the difference were with statistically significance(P<0.05).7 days after treatment,the levels of CRP,IL-6,TNF-α,CD8^+in group A were lower than those in group B,and those in group B were lower than those in group C(P<0.05).7 days after treatment,the CD4^+and CD4^+/CD8^+in group A were higher than those in group B,and those in group B were higher than those in group C(P<0.05).No adverse drug reactions occurred in the three groups during the treatment.Conclusion:HIG combined with IMP/CS and PS/TS is safe and effective in the treatment of severe pulmonary infection.It can effectively improve the inflammatory response,regulate immune function and promote the recovery of patients.
作者
巫海龙
冒山林
李向宇
顾莹
郁翰
WU Hai-long;MAO Shan-lin;LI Xiang-yu;GU Ying;YU Han(Department of Pharmacy,North Hospital of Huashan Hospital Affiliated to Fudan University,Shanghai,201907,China;Department of Critical Care Medicine,North Hospital of Huashan Hospital Affiliated to Fudan University,Shanghai,201907,China;Department of Laboratory,North Hospital of Huashan Hospital Affiliated to Fudan University,Shanghai,201907,China;Department of Pharmacy,Huashan Hospital Afiliated to Fudan University,Shanghai,200040,China)
出处
《现代生物医学进展》
CAS
2020年第18期3448-3452,共5页
Progress in Modern Biomedicine
基金
上海市科委基金资助项目(15JC1408131)。
