| 李素娟,李士荣,崔立慧,葛明坤,卞庆平.哌拉西林他唑巴坦与头孢哌酮钠舒巴坦治疗COPD合并铜绿假单胞菌感染的疗效和安全性对比[J].,2021,(13):2494-2498 |
| 哌拉西林他唑巴坦与头孢哌酮钠舒巴坦治疗COPD合并铜绿假单胞菌感染的疗效和安全性对比 |
| Comparison of Efficacy and Safety of Piperacillin Tazobactam and Cefoperazone Sodium Sulbactam in the Treatment of COPD Complicated with Pseudomonas Aeruginosa Infection |
| 投稿时间：2021-01-03 修订日期：2021-01-26 |
| DOI：10.13241/j.cnki.pmb.2021.13.019 |
| 中文关键词: 慢性阻塞性肺疾病 铜绿假单胞菌感染 哌拉西林他唑巴坦 头孢哌酮钠舒巴坦 细菌清除率 |
| 英文关键词: Chronic obstructive pulmonary disease Pseudomonas aeruginosa infection Piperacillin tazobactam Cefoperazone sodium sulbactam Bacterial clearance rate |
| 基金项目:江苏省药学会奥赛康医院药学基金项目（A201626） |
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| 摘要 目的：对比哌拉西林他唑巴坦与头孢哌酮钠舒巴坦治疗慢性阻塞性肺疾病（COPD）合并铜绿假单胞菌感染的疗效和安全性。方法：选择2017年1月至2020年1月我院呼吸科住院治疗的60例COPD合并铜绿假单胞菌感染患者纳入研究，通过抽签法分为A组和B组，各30例。A组在常规治疗基础上给予哌拉西林他唑巴坦，B组在常规治疗基础上给予头孢哌酮钠舒巴坦，均持续治疗7 d。比较A组和B组患者的临床疗效、一般治疗情况、血清实验室指标、血气指标的变化及不良反应。结果：治疗后7 d，A组患者的临床疗效、细菌清除率结果分别为93.33%、83.33%，B组为90.00%、76.67%，差异无统计学意义（P＞0.05）；A组体温正常时间、白细胞计数（WBC）正常时间、肺部炎症病灶消失时间、住院时间分别为（2.68±0.47）d、（5.05±0.53）d、（9.21±1.30）d、（10.02±1.94）d，均明显短于B组的（3.31±0.51）d、（6.52±0.60）d、（10.37±1.88）d、（11.69±1.61）d，差异均有统计学意义（P＜0.05）；治疗后3 d时，A组患者的WBC、C反应蛋白（CRP）、降钙素原（PCT）分别为（10.38±1.75）×109/L、（9.75±1.55）mg/L、（1.94±0.31）μg/L，均明显低于B组的（12.10±2.18）×109/L、（11.18±1.64）mg/L、（2.26±0.29）μg/L，治疗后7 d时，A组患者的WBC、CRP、PCT分别为（6.29±1.40）×109/L、（5.91±0.77）mg/L、（0.86±0.20）μg/L，均明显低于B组的（7.55±1.37）×109/L、（7.04±1.29）mg/L、（1.17±0.34）μg/L，差异均有统计学意义（P＜0.05）；A组患者的动脉血氧饱和度（SaO2）、血氧分压（PaO2）分别为（92.11±3.06）%、（68.37±5.13）mmHg，均明显高于B组的（88.64±3.18）%、（62.84±3.20）mmHg，二氧化碳分压（PaCO2）为（44.12±3.03）mmHg，明显低于B组的（48.49±4.21）mmHg，差异均有统计学意义（P＜0.05）。结论：哌拉西林他唑巴坦与头孢哌酮钠舒巴坦对COPD合并铜绿假单胞菌感染患者均具有较好的抗菌效果及安全性，但哌拉西林他唑巴坦可缩短恢复时间，临床应用价值更高。 |
| 英文摘要: |
| ABSTRACT Objective: To study the comparison of efficacy and safety of piperacillin tazobactam and cefoperazone sodium sulbactam in the treatment of chronic obstructive pulmonary disease(COPD) complicated with Pseudomonas aeruginosa infection. Methods: 60 cases COPD patients complicated with Pseudomonas aeruginosa infection in respiratory department of our hospital from January 2017 to January 2020 were enrolled in the study, the method of drawing lots was divided into A group and B group, 30 cases respectively. The A group was given piperacillin tazobactam on the basis of conventional treatment, and B group was given cefoperazone sodium sulbactam on the basis of conventional treatment, both of which lasted for 7 days. The clinical efficacy, general treatment, changes of serum laboratory indexes, blood gas index and adverse reactions were compared between A group and B group. Results: After treatment 7 days, the clinical efficacy and bacterial clearance rate of A group patients were 93.33% and 83.33%, respectively, while those of group B were 90.00% and 76.67%, with no significant difference(P＞0.05); the body temperature normal time, white blood cell count (WBC) normal time, pulmonary inflammatory lesions Disappearance time and the length of hospital stay in A group patients were(2.68±0.47)d, (5.05±0.53)d, (9.21±1.30)d, (10.02±1.94)d, which were significantly shorter than those of B group (3.31±0.51)d, (6.52±0.60)d, (10.37±1.88)d, (11.69±1.61)d, with significant difference(P＜0.05); at after treatment3 days, the WBC, C reactive protein (CRP) and procalcitonin (PCT) in A group patients were (10.38±1.75)×109/L, (9.75±1.55)mg/L, (1.94±0.31)μg/L, which were significantly lower than those of B group (12.10±2.18)×109/L, (11.18±1.64）mg/L, (2.26±0.29)μg/L, at after treatment7 days, the WBC, CRP and PCT in A group patients were (6.29±1.40)×109/L, (5.91±0.77)mg/L, (0.86±0.20)μg/L, which were significantly lower than those of B group(7.55±1.37)×109/L, (7.04±1.29)mg/L, (1.17±0.34)μg/L, with significant difference(P＜0.05); the arterial blood oxygen saturation (SaO2), partial pressure of oxygen (PaO2) in A group patients were (92.11±3.06)%, (68.37±5.13)mmHg, which were significantly higher than those of B group (88.64±3.18)%, (62.84±3.20)mmHg, the carbon dioxide partial pressure (PaCO2) was (44.12±3.03)mmHg, which was significantly lower than those of B group(48.49±4.21)mmHg, with significant difference(P＜0.05); the total incidence of adverse reactions in the two groups were 13.33% and 16.67%, respectively, with no significant difference(P＞0.05). Conclusion: Piperacillin tazobactam and cefoperazone sodium sulbactam have good antibacterial effect and safety on COPD complicated with pseudomonas aeruginosa infection patients, but piperacillin tazobactam can shorten the recovery time and has higher clinical application value. |
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