摘要
目的:探析大剂量乌司他丁联合哌拉西林他唑巴坦钠治疗重症肺炎合并呼吸衰竭的效果和安全性。方法:回顾性收集2021年2月-2023年4月期间本院接受乌司他丁联合哌拉西林他唑巴坦钠治疗的94例重症肺炎合并呼吸衰竭患者的临床资料。根据治疗中采用的乌司他丁剂量的不同,将患者分为应用小剂量乌司他丁(10万单位乌司他丁联合哌拉西林他唑巴坦钠治疗,47例)和大剂量组(20万单位乌司他丁联合哌拉西林他唑巴坦钠治疗,47例)。分析对比两组的炎症因子水平、肺功能、血气指标以及不良反应。结果:治疗2 w,两组的降钙素原(Procalcitonin,PCT)、C反应蛋白(C-reactive protein,CRP)水平均较治疗前降低,且大剂量组的PCT、CRP水平均显著低于对照组(P<0.05)。治疗2 w后,两组的第一秒用力呼气容积(First expiratory volume in one second,FEV1)、用力肺活量(Forced vital capacity,FVC)水平均较治疗前升高,且大剂量组的FEV1、FVC水平均显著高于对照组(P<0.05)。治疗2 w后,两组的血氧饱和度(Oxygen saturation,SaO2)、氧合指数(Oxygenation index,OI)水平均较治疗前升高,且大剂量组的SaO2、OI水平均显著高于对照组(P<0.05)。两组治疗期间的不良反应发生率比较无显著差异(P>0.05)。结论:相较于小剂量乌司他丁,大剂量乌司他丁联合哌拉西林他唑巴坦钠治疗重症肺炎合并呼吸衰竭,更能减轻全身炎症反应,改善肺功能和血气指标,且不会显著增加不良反应,安全性较高。
Objective:To explore the efficacy and safety of high-dose ulinastatin combined with piperacillin and tazobactam sodium in the treatment of severe pneumonia complicated with respiratory failure.Methods:The clinical data of 94 patients with severe pneumonia combined with respiratory failure who received ulinastatin combined with piperacillin and tazobactam sodium in our hospital from February 2021 to April 2023 were retrospectively collected.According to the dose of ulinastatin used in treatment,patients were divided into low-dose ulinastatin(100,000 units of ulinastatin combined with piperacillin and tazobactam sodium,47 cases)and high-dose ulinastatin(200,000 units of ulinastatin combined with piperacillin and tazobactam sodium,47 cases).The levels of inflammatory factors,lung function,blood gas indexes and adverse reactions of the two groups were analyzed and compared.Results:After 2 weeks of treatment,the levels of PCT and CRP in both groups were lower than before treatment,and the levels of PCT and CRP in high-dose group were significantly lower than those in control group(P<0.05).After 2 weeks of treatment,the levels of FEV1 and FVC in both groups were higher than before treatment,and the levels of FEV1 and FVC in high-dose group were significantly higher than those in control group(P<0.05).After 2 weeks of treatment,the levels of SaO2 and OI in both groups were higher than before treatment,and the levels of SaO2 and OI in high-dose group were significantly higher than those in control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Compared with low-dose ulinastatin,high-dose ulinastatin combined with piperacillin and tazobactam sodium in the treatment of severe pneumonia complicated with respiratory failure can reduce systemic inflammatory response,improve lung function and blood gas indexes,and does not significantly increase adverse reactions,with high safety.
作者
查飞
Zha Fei(Department of Pharmacy,Nanyang Rehabilitation Hospital,Nanyang 473065,Henan,China)
关键词
重症肺炎
呼吸衰竭
哌拉西林他唑巴坦钠
乌司他丁
大剂量
安全性
Severe pneumonia
Respiratory failure
Piperacillin tazobactam sodium
Ulinastatin
Large doses
Security
