社区获得性肺炎抗感染疗效及降钙素原和超敏C-反应蛋白的水平变化研究

发布时间：2019-06-06 17:57

【摘要】：目的探讨社区获得性肺炎(CAP)的抗感染疗效,观察炎症因子降钙素原(PCT)和超敏C-反应蛋白(hsCRP)在抗感染治疗前后的水平变化规律。方法选取2015年1-12月医院收治的死亡风险中等的CAP患者60例,依据抗感染方式的不同,分为左氧氟沙星组30例和β-内酰胺类联合阿奇霉素组(联合治疗组)30例,监测患者入院时、治疗期间生命体征变化,以及入院第3天及第5天血常规、血hs-CRP和PCT水平,比较两组患者治疗前后生命体征、血常规、PCT、hs-CRP、平均住院时间的差异。结果两组患者在性别、年龄及入院时生命体征(体温、呼吸、心率)方面比较,差异均无统计学意义(P0.05);随着抗感染时间的延长,左氧氟沙星组患者体温恢复正常时间短于联合治疗组(P0.05),其余生命体征指标恢复正常时间差异无统计学意义;两组患者入院时血常规、hs-CRP和PCT水平比较差异无统计学意义,入院第3天左氧氟沙星组较联合治疗组在白细胞计数(WBC)、中性粒细胞、单核细胞恢复正常的百分率比较,差异均有统计学意义(P0.05);入院第5天时hs-CRP恢复正常的百分率高于联合治疗组(P0.05)。结论与β-内酰胺类联合阿奇霉素治疗相比,左氧氟沙星治疗中度CAP患者的临床疗效似乎更好,多伴有血白细胞和炎症因子hs-CRP的更多改善。
[Abstract]:Objective to investigate the anti-infective effect of community-acquired pneumonia (CAP) and to observe the changes of inflammatory factors calmodulin (PCT) and high-sensitive C-reactive protein (hsCRP) before and after anti-infection treatment. Methods from January to December 2015, 60 patients with CAP with moderate death risk were divided into levofloxacin group (n = 30) and 尾-lactam combined with azithromycin group (n = 30) according to the different anti-infection methods. The changes of vital signs during admission and treatment, as well as blood routine, blood hs-CRP and PCT levels on the 3rd and 5th day of admission were monitored. The vital signs, blood routine and PCT,hs-CRP, were compared between the two groups before and after treatment. The difference in the average length of stay in hospital. Results there was no significant difference in sex, age and vital signs (body temperature, respiration, heart rate) between the two groups (P 0.05). With the prolongation of anti-infection time, the recovery time of body temperature in levofloxacin group was shorter than that in combined treatment group (P 0.05), but there was no significant difference in the recovery time of other vital signs. There was no significant difference in blood routine, hs-CRP and PCT levels between the two groups on admission. On the 3rd day of admission, the leukocyte count of (WBC), neutrophils and the percentage of monocytes returned to normal in levofloxacin group compared with those in combined treatment group. The difference was statistically significant (P 0.05). The percentage of hs-CRP returning to normal on the 5th day of admission was higher than that of the combined treatment group (P 0.05). Conclusion compared with 尾-lactam combined with azithromycin, levofloxacin seems to be more effective in the treatment of moderate CAP, accompanied by more improvement of leukocytes and inflammatory factor hs-CRP.
【作者单位】：绍兴文理学院附属医院呼吸内科;
【基金】：浙江省医药卫生科技计划基金资助项目(2013ZHB0111)
【分类号】：R563.1

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