两种抗生素对慢性阻塞性肺疾病急性加重并发呼吸衰竭机械通气患者的疗效比较

目的 比较复合抗生素哌拉西林钠三唑巴坦与头孢哌酮/舒巴坦钠在治疗慢性阻塞性肺病急性加重（AECOPD）并发呼吸衰竭机械通气患者中的疗效和安全性.方法 采用随机、开放、对照研究,共入选113例患者,其中试验组58例,接受哌拉西林钠三唑巴坦治疗,4.5 g,q8 h静脉注射;对照组55例,接受头孢哌酮＋舒巴坦钠治疗,2.0 g,q8 h 静脉注射.治疗5 d后评价临床和细菌学疗效. 结果 试验组总有效率81.0 %,对照组总有效率78.2 %;试验组细菌清除率80.4% ,对照组79.6% ,均差异无显著性(均P＞0.05).病原菌对哌拉西林钠三唑巴坦的敏感率为73.7%,耐药率为12.6%;对头孢哌酮＋舒巴坦钠的敏感率为75.8%,耐药率为9.5%.患者对两组药物均有良好的耐受性. 结论 哌拉西林钠三唑巴坦和头孢哌酮＋舒巴坦钠都可以作为AECOPD呼吸衰竭机械通气患者抗菌治疗的有效、安全的药物.

A Comparative Study of Combined Antibiotic in the Treatment of Acute Exacerbation of Chronic Obstructive Pulmonary Disease Accompanied Respiratory Failure with Ventilation

Objective To compare the efficacy and safety of intravenous administration of piperacilin/tazobactam with that of sulbactam/cefoperazon in the treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD) accompanied respiratory failure with ventilation. Methods A randomized,open-label,controlled study was conducted in 113 patients of AECOPD accompanied respiratory failure with ventilation.Fifty-eight patients received piperacilin/tazobactam 4.5 g q8 h,and 55 patients received sulbactam/cefoperazon 2 g q8h.The clinical and bacterio1ogical efficacies were evaluated after 5 d's treatment. Results The overall efficacy was 81.0% for piperacilin/tazobactam group and 78.2% for sulbactam/cefoperazon group;consistently,the bacterial eradication rate was 80.4% and 79.6%.The sensitivity rate and the resistance rate of the bacteriumto piperacilin/tazobactam and sulbactam/cefoperazon were 73.7%,75.8% and 12.6%,9.5%,respectively.No significant difference between these two groups was found(P>0.05).Both drugs were well tolerated. Conclusion Piperacilin/tazobactam and sulbactam/cefoperazon are effective and safety for the treatment of AECOPD accompanied respiratory failure with ventilation.