热毒宁联合左氧氟沙星治疗呼吸机相关呼吸道感染临床疗效及机制探讨

目的:探讨热毒宁联合左氧氟沙星治疗呼吸机相关呼吸道感染的临床疗效及作用机制。方法:将呼吸机相关呼吸道感染患者92例按随机数字表法分为对照组46例予左氧氟沙星治疗,研究组46例予热毒宁联合左氧氟沙星治疗,记录2组间临床症状积分、感染性参数及血清学指标变化情况,同时比较临床疗效。结果:对照组有效率为71.74%,低于研究组的91.30%,差异具有统计学意义(P0.05);与治疗前比较,2组治疗后临床症状积分、感染性参数、炎症因子均降低,治疗后CD3~+、CD4~+及CD4~+/CD8~+水平升高,CD8~+水平降低,差异具有统计学意义(P0.05);与对照组比较,研究组治疗后体温积分、咳痰积分及肺部体征积分较低,白细胞、中性粒细胞数、中性粒细胞比率、淋巴细胞数、淋巴细胞比率较低,血乳酸水平(Lac)、血清降钙素原(PCT)、白介素6(I L-6)及C-反应蛋白(CRP)水平较低,而CD3~+、CD4~+及CD4~+/CD8~+水平较高,CD8~+水平较低,差异具有统计学意义(P0.05)。结论:热毒宁联合左氧氟沙星治疗呼吸机相关呼吸道感染疗效确切,可能与降低炎症指标与感染性参数,提高免疫功能有关。

Exploration into the Mechanism and Clinical Effects of ReDuNing Combined with Levofloxacin in Treating Breathing Machine-related Respiratory Tract Infection

Objective:To discuss clinical effects and the mechanism of ReDuNing combined with levofloxacin in the treatment for breathing machine-related respiratory tract infection(RTI). Methods:All 92 patients were divided into 46 cases in the control group, who were treated by levofloxacin, and 46 cases in the experiment group, who accepted ReDuNing combined with levofloxacin, according to random number table method, clinical symptom scales, the changes of infectious parameters and serum indexes of both groups were recorded, simultaneously, clinical effects were compared. Results:The effective rate of the control group was 71.74%, lower than 91.30%of the experiment group, and the difference had statistical meaning (P<0.05);compared with before treating, clinical symptom scales, infectious parameters and inflammatory factors in both groups decreased after treating, the levels of CD3+, CD4+ and CD4+/CD8+ raised and the levels of CD8+ reduced after treating, and the difference presented statistical meaning (P<0.05);compared with the control group, body temperature scales, expectoration scales and pulmonary signs lowered after treating, white blood cells, neutrophil counting, neutrophil ratio, lymphocyte counting and lymphocyte ratio were lower after treating, the levels of Lac, PCT, IL-6 and CRP decreased, the levels of CD3+, CD4+ and CD4+/ CD8+ were higher and the levels of CD8+ were lower, and the difference presented statistical meaning (P<0.05). Conclusion:ReDuNing combined with levofloxacin could gain definite effects in the treatment for breathing machine-related RTI, which might be related to decreasing inflammatory factors and infectious parame-ters, and improving immunologic function.