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头孢哌酮钠舒巴坦钠联合参麦注射液治疗老年卒中相关性肺炎的临床观察
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| 篇名： | 头孢哌酮钠舒巴坦钠联合参麦注射液治疗老年卒中相关性肺炎的临床观察 |
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| 摘要： | 目的：观察头孢哌酮钠舒巴坦钠联合参麦注射液治疗老年卒中相关性肺炎（SAP）的疗效和安全性。 方法：选择2016年3月－2017年3月达州市中心医院收治的84例SAP患者，按随机数字表法分为对照组（42例）和观察组（42例）。在常规治疗的基础上，对照组患者给予注射用头孢哌酮钠舒巴坦钠3 g，加入5％葡萄糖注射液100 mL，静脉滴注，每日2次；并依据病原学检查及药敏试验结果选择合适的抗菌药物。观察组患者在对照组治疗的基础上给予参麦注射液100 mL，加入5％葡萄糖注射液250 mL中，静脉滴注，每日1次。两组患者均连续治疗2周。观察两组患者的临床疗效，治疗前后T淋巴细胞亚群（CD4+、CD8+、CD4+/CD8+）、炎症标志物 [血清肿瘤坏死因子α（TNF-α）、超敏C反应蛋白（hs-CRP）、降钙素原（PCT）]水平、住院时间，并记录不良反应发生情况。 结果：观察组患者总有效率（95.24％）和显效率（47.62％）均显著高于对照组的83.33％和23.81％，住院时间[（15.24±3.53）d]显著短于对照组[（18.43±4.21）d]，差异均有统计学意义（P＜0.05）。治疗后，两组患者CD4+、CD4+/CD8+水平均显著高于同组治疗前，且观察组显著高于对照组；两组患者CD8+、TNF-α、hs-CRP、PCT水平均显著低于同组治疗前，且观察组显著低于对照组，差异均有统计学意义（P＜0.05）。两组患者不良反应总发生率比较，差异均无统计学意义（P＞0.05）。结论：在常规治疗的基础上，头孢哌酮钠舒巴坦钠联合参麦注射液治疗SAP疗效显著，可有效改善患者免疫功能，降低机体炎症水平，缩短住院时间，且未增加不良反应的发生。 |
| ABSTRACT： | OBJECTIVE： To observe therapeutic efficacy and safety of cefoperazone sodium and sulbactam sodium combined with Shenmai injection in the treatment of elderly stroke associated pneumonia （SAP）. METHODS： A total of 84 SAP patients in Dazhou Municipal Central Hospital during Mar. 2016-Mar. 2017 were divided into control group （42 cases） and observation group （42 cases） according to random number table. Based on routine treatment， control group was additionally given Cefoperazone sodium and sulbactam sodium for injection 3 g added into 5％ Glucose injection 100 mL， intravenously， twice a day； suitable antibiotics were selected according to the results of pathogenic examination and drug sensitivity test. Observation group was additionally given Shenmai injection 100 mL added into 5％ Glucose injection 250 mL intravenously， once a day， on the basis of control group. Both groups were treated for consecutive 2 weeks. Clinical efficacies of 2 groups were observed， and the levels of T-lymphocyte subsets （CD4+， CD8+， CD4+/CD8+） and inflammatory markers （TNF-α， hs-CRP， PCT）， length of hospital stay before and after treatment. The ADR was recorded. RESULTS： The total response rate （95.24％） and marked response rate （47.62％） of observation group were significantly higher than those of control group （83.33％， 23.81％）； length of hospital stay in observation group [（15.24±3.53）d] was significantly shorter than control group [（18.43±4.21）d]， with statistical significance （P＜0.05）. After treatment， the levels of CD4+ and CD4+/CD8+ in 2 groups were significantly higher than before treatment， and the observation group was significantly higher than the control group； the levels of CD8+， TNF-α， hs-CRP and PCT in 2 groups were significantly lower than before treatment； the observation group was significantly lower than the control group， with statistical significance （P＜0.05）； there was no statistical significance in the incidence of ADR between 2 groups （P＞0.05）. CONCLUSIONS： Based on routine treatment， cefoperazone sodium and sulbactam sodium combined with Shenmai injection treat SAP significantly， can effectively improve immune function， reduce inflammation level and shorten the length of hospital stay without increasing the occurrence of ADR. |
| 期刊： | 2018年第29卷第8期 |
| 作者： | 冯靖雄，朱华林，黄纯友，刘丛海，彭绍贤，孙小东，唐昊，蒋东坡 |
| AUTHORS： | FENG Jingxiong，ZHU Hualin，HUANG Chunyou，LIU Conghai，PENG Shaoxian，SUN Xiaodong，TANG Hao，JIANG Dongpo |
| 关键字： | 头孢哌酮钠舒巴坦钠；参麦注射液；卒中相关性肺炎；老年；免疫功能；疗效；安全性 |
| KEYWORDS： | Cefoperazone sodium and sulbactam sodium； Shenmai injection； Stroke associated pneumonia； Elderly； Immune function； Therapeutic efficacy； Safety |
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