探讨西药药剂头孢哌酮钠舒巴坦钠临床应用效果

目的:探讨西药药剂头孢哌酮钠舒巴坦钠的临床应用效果.方法:选取我院2014年3月～2015年3月收治的炎症感染患者58例作为研究对象,按照治疗药物划分为对照组和观察组,各29例,其中对照组应用药物为头孢他啶,观察组为头孢哌酮钠舒巴坦钠,对比两组临床疗效及不良反应发生率.结果:对照组临床疗效为75.9％,明显低于观察组93.1％,对比差异有统计学意义(P＜0.05);对照组不良反应发生率为17.2％,观察组为13.8％,对比差异不明显,无统计学意义(P＞0.05).结论:西药药剂头孢哌酮钠舒巴坦钠治疗炎症感染患者效果优良,值得推广.     

头孢哌酮钠舒巴坦钠治疗肝硬化并发自发性细菌性腹膜炎的临床研究

目的研究头孢哌酮钠舒巴坦钠治疗肝炎后肝硬化并发自发性细菌性腹膜炎(SBP)的临床效果。方法选取我院2011年1月~2013年12月肝炎后肝硬化并发SBP患者68例,随机分为观察组和对照组各34例。观察组给予头孢哌酮钠舒巴坦钠治疗,对照组给予左氧氟沙星治疗,比较两组患者的临床疗效。结果观察组总有效率明显高于对照组,两组比较差异具有统计学意义(P0.05)。结论头孢哌酮钠舒巴坦钠治疗肝炎后肝硬化并发SBP疗效显著,值得临床推广应用。     

氨溴索联合头孢哌酮钠舒巴坦钠治疗老年COPD合并肺部感染的临床疗效及对炎性因子的影响

目的 研究头孢哌酮钠舒巴坦钠联合氨溴索对慢性阻塞性肺疾病(Chronic Obstructive Pulmonary Disease, COPD)合并肺部感染的患者肺功能及炎症因子水平的影响。方法 选取2020年1月—2022年12月徐州市矿山医院收治的70例COPD合并肺部感染患者为研究对象,按随机数表法分为两组,各35例。对照组在常规治疗基础上给予头孢哌酮钠舒巴坦钠治疗,联合组在对照组基础上给予氨溴索治疗。比较两组的肺功能指标、炎症指标、不良反应情况。结果 观察组总有效率(94.29%)高于对照组(77.14%),差异有统计学意义(χ²=4.200,P=0.040);治疗后,观察组肺功能指标高于对照组,血白细胞计数、C反应蛋白、白介素-6、白介素-8低于对照组,差异有统计学意义(P均<0.05)。两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论 头孢哌酮钠舒巴坦钠联合氨溴索治疗COPD合并肺部感染的患者疗效好,可显著改善肺功能及炎症反应,安全性好。     

头孢哌酮钠舒巴坦钠联用阿奇霉素治疗阴性菌高危因素社区获得性肺炎的效果研究

目的探讨头孢哌酮钠舒巴坦钠联用阿奇霉素治疗阴性菌高危因素社区获得性肺炎(CAP)的效果。方法我院收治的阴性菌高危因素CAP患者120例,采用随机数表法分为观察组和对照组各60例,对照组给予阿奇霉素联合头孢他啶治疗,观察组给予阿奇霉素联合头孢哌酮钠舒巴坦钠治疗,比较两组治疗有效率,记录其咳嗽消失时间、啰音消失时间、气促停止时间、退热时间、住院时间,测定白细胞计数(WBC)、降钙素原(PCT)、C反应蛋白(CRP)水平变化,同时记录治疗后细菌清除率及不良反应。结果观察组治疗有效率高于对照组83.33%;咳嗽消失时间、啰音消失时间、气促停止时间、退热时间、住院时间与对照组比较明显缩短;治疗后WBC及血清PCT、CRP明显低于对照组;细菌清除率高于对照组(P0.05);两组不良反应发生率差异无统计学意义(P0.05)。结论头孢哌酮钠舒巴坦钠联合阿奇霉素治疗阴性菌高危因素CAP疗效较好,可较好改善患者症状及炎症因子水平,提高细菌清除率,不会明显增加不良反应,值得在临床推广应用。     

胸腺五肽联合头孢哌酮钠舒巴坦钠对老年糖尿病并肺部感染的疗效及血清C反应蛋白和白细胞介素-6水平的影响

目的探讨胸腺五肽联合头孢哌酮钠舒巴坦钠对老年糖尿病合并肺部感染患者的疗效及对患者血清C反应蛋白(CRP)、白细胞介素-6(IL-6)水平的影响。方法 86例老年糖尿病合并肺部感染患者按照随机数字表法分为研究组(胸腺五肽联合头孢哌酮钠舒巴坦钠治疗,43例)和对照组(单纯应用头孢哌酮钠舒巴坦钠治疗,43例)。比较两组患者治疗前后空腹血糖值、血清CRP、血清IL-6、临床疗效、不良反应发生率等指标的差异。结果研究组患者体温、肺部啰音恢复、肺部阴影吸收及咳嗽咳痰减轻所需时间均短于对照组(P均0.05)。研究组临床治疗有效率为95.35%(41/43),对照组为81.40%(35/43),研究组高于对照组(P0.05)。经治疗,两组患者的血清CRP、IL-6水平均低于治疗前(P均0.05),且研究组低于对照组(P均0.05)。研究组中,恶心呕吐1例,发生率为2.32%,对照组中,恶心呕吐3例、上腹不适2例、皮疹2例,发生率为16.28%,研究组低于对照组(P0.05)。结论胸腺五肽联合头孢哌酮钠舒巴坦钠治疗老年糖尿病合并肺部感染,临床疗效优于单纯使用头孢哌酮钠舒巴坦,且不良反应少。     

硫酸黏菌素联合头孢哌酮钠舒巴坦钠治疗多重耐药鲍曼不动杆菌的疗效

目的：探讨硫酸黏菌素联合头孢哌酮钠舒巴坦钠治疗多重耐药鲍曼不动杆菌肺炎的疗效分析。方法：选择2019年3月至2021年7月太原市中心医院收治的76例多重耐药鲍曼不动杆菌肺炎患者为研究对象,按照随机数字表法分为对照组(n=37)与观察组(n=39)。对照组静脉滴注注射用头孢哌酮钠舒巴坦钠,3 g加入到0.9%氯化钠溶液100 m L中,每隔6 h静脉滴注1次;观察组静脉滴注注射用头孢哌酮钠舒巴坦钠联合注射用硫酸黏菌素,用法为硫酸黏菌素100万U/d,分2次静脉滴注。两组疗程均为14 d。观察两组患者的临床疗效,比较两组患者白细胞计数(white blood cell count,WBC)、血清C反应蛋白(C-reactionprotein,CRP)、降钙素原(procalcitonin,PCT)水平以及不良反应。结果：观察组与对照组有效率差异有统计学意义(P<0.05);观察组WBC、CRP和PCT水平显著低于对照组(P<0.05)。结论：针对多重耐药鲍曼不动杆菌肺炎患者,硫酸黏菌素联合头孢哌酮钠舒巴坦钠有效率、炎症指标优于单用头孢哌酮钠舒巴坦钠组,不良反应无明显增加。     

痰热清合注射用头孢哌酮钠舒巴坦钠治疗小儿支气管肺炎

目的:探究小儿支气管肺炎采用痰热清注射液联合注射用头孢哌酮钠舒巴坦钠治疗的临床疗效。方法:选取2017年4月～2018年5月我院收治的102例支气管肺炎患儿作为研究对象,根据治疗方案不同分为观察组和对照组,每组51例。对照组在常规治疗的基础上采用注射用头孢哌酮钠舒巴坦钠治疗,观察组在对照组的治疗基础上加用痰热清注射液。比较两组临床疗效、临床症状(咳嗽、发热、肺部湿啰音、气喘)消失时间和不良反应发生情况。结果:观察组总有效率为96.08%,高于对照组的82.35%,差异有统计学意义,P0.05;观察组体温复常、止咳、气喘消失和肺部湿啰音消失时间均较对照组短,差异有统计学意义,P0.05;观察组不良反应发生率为11.76%,与对照组的7.84%相比较,差异无统计学意义,P0.05。结论:痰热清注射液与注射用头孢哌酮钠舒巴坦钠联合治疗小儿支气管肺炎可显著提高临床疗效,快速缓解临床症状,不良反应发生率低。     

阿奇霉素与头孢哌酮钠舒巴坦钠联合治疗老年肺炎的效果

目的研究阿奇霉素、头孢哌酮钠舒巴坦钠联合治疗老年肺炎患者的临床价值。方法选取新乡市第一人民医院2018年2月至2019年2月收治的40例老年肺炎患者为研究对象,随机分为两组,每组20例。对照组应用亚胺培南西司他汀与左氧氟沙星联合治疗,试验组患者静脉注射头孢哌酮巴坦钠与阿奇霉素。比较试验组与对照组患者的血液中促炎因子指标、临床治疗效果及不良反应等指标。结果治疗后,试验组白细胞介素(IL)-6水平为(10.43±2.22)ng/L,对照组IL-6水平为(11.78±2.67)ng/L,差异有统计学意义(P0.05)。试验组中,痊愈6例,显效9例,好转3例,无效2例,治疗有效率为90.0%(18/20),显著高于对照组治疗有效率(75.0%,15/20),差异有统计学意义(P0.05)。对照组1例患者发生腹泻,1例患者发生恶心呕吐。试验组1例患者发生头痛,1例患者呕吐,不良反应发生率均为10.0%,差异未见统计学意义(P0.05)。结论阿奇霉素、头孢哌酮钠舒巴坦钠联合治疗老年肺炎患者的临床效果理想,不良反应发生率低,可显著改善患者机体炎症状态,缓解临床症状。     

头孢哌酮钠舒巴坦钠治疗重症下呼吸道医院感染的临床疗效

目的分析头孢哌酮钠舒巴坦钠治疗重症下呼吸道医院感染的临床疗效。方法按照平行分组法将我院收治的86例重症下呼吸道医院感染患者分为治疗组(43例)和对照组(43例),治疗组实施头孢哌酮钠舒巴坦钠治疗,对照组实施头孢他啶治疗,分析其临床疗效。结果两组患者治疗总有效率、细菌清除率及不良反应对比,差异无统计学意义(P0.05)。结论头孢哌酮钠舒巴坦钠治疗重症下呼吸道医院感染效果显著,抗菌谱广,副作用少,可作为治疗重症下呼吸道医院感染的理想方法。     

头孢哌酮钠舒巴坦钠的临床应用效果及不良反应研究

目的:研究头孢哌酮钠舒巴坦钠的临床应用效果及不良反应。方法:选取2017年3月～2018年3月就诊的108例需抗感染治疗的患者作为研究对象,每位患者均在对症治疗的基础上给予头孢哌酮钠舒巴坦钠治疗,观察其临床疗效及发生不良反应的概率和症状。结果:临床有效率为93.52%;不良反应发生率为21.30%,其中以皮肤损害和胃肠系统损害较常见。结论:头孢哌酮钠舒巴坦钠用于治疗感染疗效显著,但其不良反应也应引起临床注意,临床使用时应根据患者体质、饮食和联合用药情况规范合理地使用,并加强用药监控,保证疗效的同时尽量避免不良反应的发生。     

Cefoperazone sodium/sulbactam sodium vs piperacillin sodium/tazobactam sodium for treatment of respiratory tract infection in elderly patients

BACKGROUNDRespiratory tract infections in the elderly are difficult to cure and can easily recur, thereby posing a great threat to patient prognosis and quality of life.AIMTo investigate the therapeutic effects of different antibiotics in elderly patients with respiratory tract infection. METHODSSeventy-four elderly patients with respiratory tract infection were randomly allocated to a study (n = 37; treated with cefoperazone sodium/sulbactam sodium) or control (n = 37; treated with piperacillin sodium/tazobactam sodium on the basis of routine symptomatic support) group. Both groups were treated for 7 d. Time to symptom relief (leukocyte recovery; body temperature recovery; cough and sputum disappearance; and rale disappearance time), treatment effect, and laboratory indexes [procalcitonin (PCT), C-reactive protein (CRP), white blood cell count (WBC), and neutrophil percentage (NE)] before and 7 d after treatment and the incidence of adverse reactions were assessed.RESULTSIn the study group, the time to WBC normalization (6.79 ± 2.09 d), time to body temperature normalization (4.15 ± 1.08 d), time to disappearance of cough and sputum (6.19 ± 1.56 d), and time to disappearance of rales (6.68 ± 1.43 d) were shorter than those of the control group (8.89 ± 2.32 d, 5.81 ± 1.33 d, 8.77 ± 2.11 d, and 8.69 ± 2.12 d, respectively; P = 0.000). Total effective rate was higher in the study group (94.59% vs 75.68%, P = 0.022). Serum PCT (12.89 ± 3.96 μg/L), CRP (19.62 ± 6.44 mg/L), WBC (20.61 ± 6.38 × 10⁹/L), and NE (86.14 ± 7.21%) levels of the study group before treatment were similar to those of the control group (14.05 ± 4.11 μg/L, 18.79 ± 5.96 mg/L, 21.21 ± 5.59 × 10⁹/L, and 84.39 ± 6.95%, respectively) with no significant differences (P = 0.220, 0.567, 0.668, and 0.291, respectively). After 7 d of treatment, serum PCT, CRP, WBC, and NE levels in the two groups were lower than those before treatment. Serum PCT (2.01 ± 0.56 μg/L), CRP (3.11 ± 1.02 mg/L), WBC (5.10 ± 1.83 × 10⁹/L), and NE (56.35 ± 7.17%) levels were lower in the study group than in the control group (3.29 ± 0.64 μg/L, 5.67 ± 1.23 mg/L, 8.13 ± 3.01 × 10⁹/L, and 64.22 ± 8.08%, respectively; P = 0.000). There was no significant difference in the incidence of adverse reactions between the groups (7.50% vs 12.50%, P = 0.708).CONCLUSIONPiperacillin sodium/tazobactam sodium is superior to cefoperazone sodium/ sulbactam sodium in the treatment of elderly patients with respiratory tract infection with a similar safety profile.     

美洛西林钠舒巴坦对肺炎患者的治疗机制研究

目的：探究美洛西林钠舒巴坦对肺炎患者的治疗效果以及作用机制。方法将2012年2月至2014年2月将收治的164例肺炎患者平均随机分为两组,每组各82例。研究组采用美洛西林钠舒巴坦进行静脉滴注,对照组采用美洛西林钠进行静脉滴注,2周后比较两组患者的治疗有效情况、临床体征和不良反应。结果2周后,研究组患者治疗全部有效,即有效率达100％,同时77例痊愈,痊愈率高达93．9％;对照组患者治疗全部有效,即有效率达100％,同时30例痊愈,痊愈率仅有36．6％,两组差异有统计学意义（χ2＝13．35,P ＝0．0012＜0．05）。并且,研究组患者的临床体征消失的平均时间早于对照组,差异有统计学意义（P ＜0．05）。在不良反应方面,研究组出现2例,不良反应率为2．4％;对照组出现10例,不良反应率高达12．2％,差异有统计学意义（t ＝6．35,P ＝0．0057＜0．05）。结论相对于美洛西林钠,美洛西林钠舒巴坦更能较快、较好地治疗肺炎,并且其不良反应小,值得在临床上进行合理应用。     

Cell membrane handling of sodium in lymphocytes during salt restriction in normotensives

Lymphocyte sodium content and sodium efflux were studied in 9 healthy normotensive males without history of essential hypertension before, during and after 5 weeks of severe sodium depletion. Sodium depletion caused a significant increase in sodium content and a slight but non-significant decrease in potassium content. Total and ouabain-sensitive sodium efflux rate constants decreased significantly during sodium depletion, while absolute sodium efflux, derived from cellular sodium concentration and the corresponding sodium efflux rate constants, remained unchanged. A significant reduction in arterial mean and diastolic blood pressure, measured by ambulatory as well as by home readings, was observed during salt restriction. Prolonged severe sodium depletion of normotensive subjects leads to changes in lymphocytic sodium homeostasis, probably due to a primary inhibition of the sodium pump and a secondary intralymphocytic sodium accumulation. The mechanism underlying these changes remains unclarified.     

注射用哌拉西林钠他唑巴坦钠致全身肌肉震颤伴麻木感一例

注射用哌拉西林钠他唑巴坦钠可用于全身和（或）局部感染,包括软组织感染、细菌性败血症、骨关节感染、多重细菌感染,可疑感染部位存在的各种细菌感染,为烧伤与创面治疗常用抗炎药物,其不良反应常见有皮肤反应、胃肠道症状及过敏反应,而出现中枢神经系统症状,如抽搐或麻木等则极为罕见。结合该例病历资料及相关文献进行回顾性分析,对1例注射用哌拉西林钠他唑巴坦钠致全身肌肉震颤伴麻木感的临床诊治进行总结报道,以期引起临床医师的重视,同时提高对该类药物不良反应的重视,减少不良反应的发生。     

Naproxen sodium in the treatment of migraine

Seventy patients with classical or common migraine were treated during their attacks with either naproxen sodium or placebo in a randomised, double-blind parallel group study. The initial dose of naproxen sodium was 825 mg followed one hour later by a further 550 mg, if symptoms were the same or had improved. If the migraine symptoms had worsened, patients were offered an escape analgesic combination of 1000 mg paracetamol and 10 mg metoclopramide. Patients were assessed at monthly intervals for changes in the severity and duration of headache, premonitory symptoms (mainly visual disturbances) and photophobia, nausea and vomiting associated with migraine attacks that had occurred since the previous visit. Patients were studied for a maximum of ten attacks and significant improvement was observed in the severity and duration of headache when the patients were on naproxen sodium. Also the premonitory symptoms and photophobia improved significantly on naproxen sodium and significantly less rescue analgesics were required. Patients suffering from common migraine had less severe headaches and photophobia when taking naproxen sodium than when taking placebo and the headaches were shorter in duration and patients took less rescue analgesic. No significant difference was observed between the treatment groups in patients with classical migraine. Ten patients in the placebo group and six in the naproxen sodium group reported side-effects but these were possibly related to the use of rescue medication. Naproxen sodium proved safe and effective in common migraine attacks, but in this study efficacy was not established for classical migraine.     

头孢哌酮钠促溶方法对比研究

目的 探讨头孢哌酮钠的促溶方法。方法 采用36支(1g/支)注射用头孢哌酮钠进行试验，将每支分为三等分后分别纳入加温促溶组、机械振荡组、碳酸氢钠促溶组进行溶解试验，比较各组溶解情况。结果 从溶解速度来看，机械振荡组最快，碳酸氢钠促溶组其次，加温促溶组最慢，其中仅碳酸氢钠促溶组未出现再凝。结论 碳酸氢钠促溶是可行的方法。     

Dietary sodium intake is associated with long-term risk of new-onset atrial fibrillation

Abstract

Background: The association between dietary salt intake and hypertension has been well documented. We evaluated the association between dietary sodium intake and the incidence of new-onset atrial fibrillation (AF) during a mean follow-up of 19 years among 716 subjects from the Oulu Project Elucidating Risk of Atherosclerosis (OPERA) cohort.

Material and methods: Dietary sodium intake was evaluated from a seven-day food record. The diagnosis of AF (atrial flutter included) was made if ICD-10 code I48 was listed in the hospital discharge records during follow-up.

Results: In the Kaplan-Meier curves, when quartiles of sodium consumption were considered, the cumulative proportional probabilities for AF events were higher in the highest (4th) quartile (16.8%) than in the lower quartiles (1st 6.7%, 2nd 7.3% and 3rd 10.6%) (p?=?.003). In the Cox regression analysis, sodium consumption (g/1000?kcal) as a continuous variable was independently associated with AF events (Hazard Ratio?=?2.1 (95% CI, 1.2 to 3.7) p?=.015) when age, body mass index, smoking (pack-years), office systolic blood pressure, left atrium diameter, left ventricular mass index and the use of any antihypertensive therapy were added as covariates.

Conclusions: These findings indicate that sodium intake is associated with the long-term risk of new-onset AF. Further confirmatory studies are needed.

• Key messages

• Sodium consumption correlated positively with CV risk factors: age, smoking, SBP, BMI and LDL-cholesterol.

• When quartiles of sodium consumption were considered, the AF incidence was higher in the highest quartile compared to lower quartiles.

• Sodium consumption as a continuous variable was independently associated with AF events when age, BMI, smoking, SBP, LAD, LVMI and the use of any antihypertensive therapy were considered.

     

联机血钠监测个体化低钠透析模式对水钠平衡和血压的影响

目的探讨联机血浆钠浓度监测的准确性,观察个体化低钠透析模式对患者水钠平衡、血压的影响及透析过程中不良反应。方法选择40例维持性血液透析患者,联机血钠监测及生化法测得血钠浓度对比,并对每例患者各行标准钠透析及个体化低钠血液透析。对两种透析模式透析前后血浆钠浓度等临床指标及不良反应进行比较。结果 40例患者行标准钠透析中联机血钠监测测定血浆钠浓度进行比较。测得联机血钠浓度138±3mmol/L,自动生化分析仪法血浆钠浓度为138.0±2.8mmol/L,2者比较差异无统计学意义(P=0.06)。将2种方法测量值作散点图,2者呈直线相关。两者的直线回归相关指数r=0.823,r2=0.677,回归系数t值为4.309,P<0.001。个体化低钠透析模式血钠浓度、收缩压(153.94±22.02mmHg和148.07±21.23mmHg,P=0.013)、口渴程度(54例次与98例次,P<0.001)均明显降低,不良事件发生率低。结论联机血钠监测测得的血钠浓度与常规生化分析结果相关性好;个体化低钠透析模式能明显降低透后血钠浓度、收缩压、口渴程度及透析期间体质量增长,不良事件发生率低,安全性好。     

奥扎格雷氯化钠注射液治疗老年糖尿病下肢动脉病变的临床研究

目的 观察奥扎格雷氯化钠注射液治疗老年糖尿病下肢动脉病变的效果.方法 80例老年糖尿病患者随机分为2组,均给予常规治疗.治疗组给予奥扎格雷氯化钠注射液100 ml,每日2次;对照组给予丹参注射液800 mg加入生理盐水250 ml中,每日静脉滴注1次;均3周为1疗程.观察治疗前后血糖、TC、TG、SCr、ALT和足背动脉血流量指标的变化.结果 治疗组总有效率为92.5%.对照组为85.0%,2组总有效率比较差异有统计学意义(χ2=3.99,P＜0.05);足背动脉血流速度治疗组、对照组分别为(0.65 ±0.16)、(0.61 ±0.10)(v·s)/m,2组比较差异有统计学意义(t=2.16,P＜0.05);踝/肱血压指数治疗组与对照组分别为(0.99±0.29)、(0.92±0.13),2组比较差异有统计学意义(t=2.45,P＜0.05).结论 奥扎格雷氯化钠注射液有助于老年糖尿病下肢动脉病变的治疗.     

哌拉西林钠/他唑巴坦钠联合莫西沙星治疗COPD合并急性下呼吸道感染的临床观察

目的观察哌拉西林钠/他唑巴坦钠联合莫西沙星治疗COPD合并急性下呼吸道感染患者的临床疗效。方法选取120例COPD合并急性下呼吸道感染患者随机分为3组,对照1组(40例)给予哌拉西林钠/他唑巴坦抗感染治疗;对照2组(40例)给予莫西沙星抗感染治疗;联合治疗组(40例)给予哌拉西林钠/他唑巴坦联合莫西沙星联合治疗。分别于治疗前后比较急性生理与慢性健康评分(APACHEⅡ)及呼吸困难评分;并分析痰样本,对比治疗后的细菌清除率、真菌感染率及临床疗效。结果联合治疗组的总有效率为87.5%,对照1组和对照2组总有效率分别为57.5%和62.5%,组间比较差异显著(P0.05);联合治疗组APACHEⅡ和呼吸困难得分低于对照1组和对照2组(P0.01)。联合治疗组细菌清除率高于对照1组和对照2组(P0.01)且联合治疗组在抗感染方面体现极显著优越性(P0.01)。结论联合使用抗生素治疗COPD合并急性下呼吸道感染可减少不必要的细菌侵入,可有效地防治COPD患者的真菌感染,改善其预后。