血必净联合头孢哌酮舒巴坦钠与左氧氟沙星对重症社区获得性肺炎患者免疫功能、凝血功能及疗效的影响

目的:探讨血必净联合头孢哌酮舒巴坦钠与左氧氟沙星对重症社区获得性肺炎(SCAP)患者免疫功能、凝血功能及疗效的影响。方法:将2015年7月至2017年12月期间某院收治的重症社区获得性肺炎患者98例依抽签法分为对照组(n=49)和观察组(n=49),2组均予以常规对症治疗,在此之上,对照组予以头孢哌酮舒巴坦钠联合左氧氟沙星治疗方案,观察组在对照组基础上加用血必净治疗。对比分析2组免疫功能、凝血功能、临床疗效及不良反应。结果:治疗后,2组SCAP患者CD4^+、CD4^+/CD8^+水平均与治疗前比显著升高(P<0.05),而CD8^+与治疗前比显著降低,且观察组CD4^+、CD4^+/CD8^+水平显著高于对照组(P<0.05),CD8^+水平显著低于对照组(P<0.05);对照组APTT、TT、DD水平显著高于其治疗前及观察组(P<0.05),而FIB水平显著低于其治疗前及观察组(P<0.05);且治疗后观察组APTT、TT、FIB、DD水平与治疗前比无显著性差异(P>0.05)。观察组临床总有效率显著高于对照组(χ^2=4.780,P<0.05)。观察组机械通气时间、ICU住院时间、中医证候积分及CPIS评分显著低于对照组(P<0.05)。2组病死率及病原学阳性率差异无显著性(P>0.05),观察组细菌清除率显著高于对照组(P<0.05)。2组不良反应比较差异无显著性(χ^2=0.122,P=0.727)。结论:血必净联合头孢哌酮舒巴坦钠与左氧氟沙星是治疗SCAP患者的有效方案,该方案可改善患者的免疫功能及凝血功能,同时提高其临床疗效,改善其临床症状,细菌清除率高,不良反应少,具有临床推广意义。

Effects of Xuebijing combined with cefoperazone sulbactam sodium and levofloxacin on immune function,coagulation function and therapeutic effect in patients with severe community acquired pneumonia

OBJECTIVE To explore the effects of Xuebijing combined with cefoperazone sulbactam sodium and levofloxacin on immune function, coagulation function and therapeutic effect in patients with severe community acquired pneumonia. METHODS 98 patients with severe community acquired pneumonia admitted to our hospital from July 2015 to December 2017 were divided into control group (n=49) and observation group (n=49), and both groups were given routine symptomatic treatment. On this basis, the control group was given cefoperazone sulbactam sodium combined with levofloxacin, and the observation group was additionally treated with Xuebijing on the basis of the control group. Immune function, coagulation function, clinical efficacy and adverse reactions were compared between the two groups. RESULTS After treatment, the levels of CD4⁺, CD4⁺/CD8⁺ in SCAP patients in both groups were significantly higher than those before treatment (P<0.05), while the levels of CD8⁺ were significantly lower than those before treatment, and the levels of CD4⁺, CD4⁺/CD8⁺ in the observation group were significantly higher than those in the control group (P<0.05), and the levels of CD8⁺ in the observation group were significantly lower than those in the control group (P<0.05); the levels of APTT, TT and DD in the control group were significantly higher than those before treatment and in the observation group (P<0.05), while the levels of FIB were significantly lower than those before treatment and in the observation group (P<0.05); there was no significant difference in APTT, TT, FIB and DD before and after treatment in the observation group (P>0.05). The total effective rate of the observation group was significantly higher than that of the control group (χ²=4.780, P<0.05). The mechanical ventilation time, ICU hospitalization time, TCM syndrome score and CPIS score in the observation group were significantly lower than those in the control group (P<0.05). There was no significant difference in mortality and positive rate of etiology between the two groups (P>0.05), the bacterial clearance rate in the observation group was significantly higher than that in the control group (P<0.05). There was no significant difference in adverse reactions between the two groups (χ²=0.122, P=0.727). CONCLUSION Xuebijing combined with cefoperazone sulbactam sodium and levofloxacin is an effective regimen in the treatment of SCAP patients. The regimen can improve the immune function and coagulation function of patients, and improve the clinical efficacy and its clinical symptoms with a high bacterial clearance rate and fewer adverse reactions, and deserves to be promoted in clinical practice.