| 强丽霞 藏伟佳 李香顺 赵婷婷 吕娜 金寿德 王凤爽.抗生素单剂与联合治疗社区获得性肺炎的临床疗效观察[J].,2015,15(24):4672-4676 |
| 抗生素单剂与联合治疗社区获得性肺炎的临床疗效观察 |
| Clinical Efficacy of Single Versus Combination Antibiotic Therapy inCommunity Acquired Pneumonia |
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| DOI： |
| 中文关键词: beta内酰胺类 大环内酯类 社区获得性肺炎 经验性治疗 |
| 英文关键词: beta-lactam Macrolide Community-acquired pneumonia Empiric therapy |
| 基金项目:黑龙江省留学归国基金项目（LC201024） |
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| 中文摘要: |
| 目的：观察beta内酰胺类联合大环内酯类与茁内酰胺类单剂治疗社区获得性肺炎的临床疗效。方法：收集我院呼吸内科住院
的社区获得性肺炎患者262 例，随机分为单剂治疗组和联合治疗组。两组患者均给予抗感染、对症支持治疗，其中单剂治疗组抗
生素采用beta内酰胺酶类单剂治疗，联合治疗组采用beta内酰胺酶类和大环内酯类联合治疗。所有患者统计年龄、性别、基础疾病、病
情严重程度，并记录治疗前与治疗后不同住院天数的血常规、C 反应蛋白的变化，统计住院天数。结果：联合治疗患者一般基本情
况（年龄、性别、基础疾病、病情严重程度）与单剂治疗组相比，P >0.05，差异均无统计学意义。治疗前及治疗后首日C 反应蛋白和
白细胞计数二者相比，P>0.05，差异均无统计学意义；联合治疗组与单剂治疗组相比，C 反应蛋白在住院第2、4、6、9 天，白细胞计
数在住院第2、4、6 天，均明显下降，住院天数缩短，P <0.05，差异均有统计学意义。对于中、重度CAP(CRB65≥ 2)，联合治疗组与单
剂治疗组相比，治疗后C 反应蛋白以及白细胞计数明显减少，P均<0.05, 差异有统计学意义；对于轻度CAP（CRB65=0~1），两组
治疗后CRB 和白细胞计数相比，P 均＞0.05，差异无统计学意义。结论：beta内酰胺类联合大环内酯类治疗治疗社区获得性肺炎临床
疗效优于beta内酰胺类单剂治疗。 |
| 英文摘要: |
| Objective:To investigate the clinical efficacy of beta-lactam/macrolide versus beta-lactam monotherapy in community-acquired
pneumonia.Methods:262 community-dwelling patients with pneumonia who hospitalized were observed. All patients receiving
antibiotics and supportive treatment were randomly divided into single therapy group with beta-lactamases and combination therapy group
with beta-lactamases and macrolides. All patients were assessed at the presentation. In all cases, the age, sex, complication, illness severity
and hospital day of the patients were recorded. White blood cell count and C-reactive protein before and after treatment was detected, and
the days of hospitalization were recorded.Results:Basic information including age, sex, underlying disease, severity of illness, and C-reactive
protein and white blood cell counts before treatment and the first day after treatment were not significantly different (P>0.05) between
the single-dose treatment group and combination therapy. C-reactive protein in the hospital 2, 4, 6, 9 days, the white blood cell
count in 2,4,6 days in hospital, were significantly decreased and the days of hospitalization were shortened, and the difference was statistically
significant (P<0.05). What's more, for the moderate and severe CAP（CRB65≥ 2）, there was statistical significance in C-reactive
protein and white blood cell count after treatment between two groups (P<0.05). However, for the mild CAP(CRB65=0~1), the difference
of C-reactive protein and white blood cell counts between the two groups after treatment was not statistically significant (P＞0.05).Conclusion:Combination therapy of beta-lactam and macrolide might be more effective than beta-lactam single-agent therapy for elderly community
acquired pneumonia. |
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