摘要
目的探讨利奈唑胺联合亚胺培南西司他丁辅助常规抗结核疗法治疗肺结核合并重症肺炎的临床疗效与安全性。方法选取医院结核科与重症监护室2020年1月至2024年3月收治的肺结核合并重症肺炎住院患者312例,按随机数字表法分为对照组和观察组,各156例。对照组患者采用常规抗结核疗法联合亚胺培南西司他丁治疗,观察组患者在对照组治疗基础上加用利奈唑胺。两组患者均连续治疗2周,随访12个月。结果观察组治疗总有效率为85.90%,细菌清除率为88.46%,1年生存率为92.31%,分别显著高于对照组的77.56%,64.74%,85.26%(P<0.05)。免疫功能动态监测示,观察组患者治疗1周、2周后的T淋巴细胞CD_(3)^(+),CD_(4)^(+),CD_(4)^(+)/CD_(8)^(+)升高幅度均显著大于对照组同期(P<0.05);观察组患者治疗1周、2周后的CD_(8)^(+)、降钙素原、C反应蛋白、白细胞介素6降低幅度均显著大于对照组同期(P<0.05),观察组患者的中性粒细胞计数在治疗1周后显著回升(P<0.01)。治疗1周后,对照组患者的丙氨酸氨基转移酶及肌酐清除率均显著升高(P<0.05),但组间无显著差异(P>0.05)。观察组与对照组患者不良反应发生率相当(4.49%比3.85%,P>0.05)。结论利奈唑胺联合亚胺培南西司他丁辅助常规抗结核疗法治疗肺结核合并重症肺炎的临床疗效良好,展现了强效协同抑菌的特性,在促进机体免疫功能恢复及减轻炎性损伤方面优势明显,且安全性较好。
Objective To investigate the clinical efficacy and safety of linezolid combined with imipenem cilastatin as an adjuvant therapy for conventional anti-tuberculosis therapy in the treatment of pulmonary tuberculosis complicated with severe pneumonia.Methods A total of 312 inpatients with pulmonary tuberculosis complicated with severe pneumonia admitted to the Department of Tuberculosis and Intensive Care Unit of the hospital from January 2020 to March 2024 were selected and randomly divided into the control group and the observation group by the random number table method,with 156 cases in each group.The patients in the control group were treated with conventional anti-tuberculosis therapy combined with imipenem cilastatin,while the patients in the observation group were additionally treated with linezolid.Both groups were treated continuously for 2 weeks and followed up for 12 months.Results The total effective rate was 85.90%,the bacterial clearance rate was 88.46%,and 1-year survival rate was 92.31%in the observation group,which were significantly higher than 77.56%,64.74%,and 85.26%in the control group(P<0.05).The dynamic monitoring of immune function showed that the increase in T lymphocyte CD_(3)^(+),CD_(4)^(+),CD_(4)^(+)/CD_(8)^(+)in the observation group after 1 and 2 weeks of treatment was significantly greater than that in the control group during the same period(P<0.05);the decrease in CD_(8)^(+),the levels of procalcitonin,C-reactive protein,and interleukin-6 in the observation group after 1 and 2 weeks of treatment was significantly greater than that in the control group during the same period(P<0.05);the neutrophil count in the observation group significantly increased after 1 week of treatment(P<0.01).After 1 week of treatment,the alanine aminotransferase and creatinine clearance rates in the control group significantly increased(P<0.05),but there was no significant difference between the two groups(P>0.05).The incidence of adverse reactions in the observation group was comparable to that in the control group(4.49%vs.3.85%,P>0.05).Conclusion Linezolid combined with imipenem as an adjuvant therapy for conventional anti-tuberculosis therapy has a good clinical efficacy and safety in the treatment of pulmonary tuberculosis complicated with severe pneumonia,and it demonstrated strong synergistic antibacterial properties.It has significant advantages in promoting the recovery of immune function and reducing inflammatory damage.
作者
李娅敏
成松
孙景坤
张礼营
彭乐
袁苗
LI Yamin;CHENG Song;SUN Jingkun;ZHANG Liying;PENG Le;YUAN Miao(Xuzhou Infectious Disease Hospital,Xuzhou,Jiangsu 221000,China)
出处
《中国药业》
2026年第1期99-103,共5页
China Pharmaceuticals
基金
江苏省徐州市科技项目[KC23206]。
