摘要
目的探讨替加环素联合盐酸氨溴索纤维支气管镜肺泡灌洗治疗重症肺炎的疗效。方法选择2021年3月至2024年3月虞城县人民医院收治的重症肺炎患者60例,采用随机数字表法分为对照组和观察组,每组30例。对照组采用盐酸氨溴索纤维支气管镜肺泡灌洗,观察组在对照组治疗基础上加用注射用替加环素静脉滴注。两组均治疗7 d后判定疗效。比较两组肺功能指标[第1秒用力呼气容积(FEV_(1))、呼气流量峰值(PEF)和用力肺活量(FVC)]、动脉血气指标[二氧化碳分压(PaCO_(2))、血氧饱和度(SaO_(2))、动脉血氧分压(PaO_(2))]、免疫指标(CD8^(+)、CD4^(+)、CD3^(+)、CD4^(+)/CD8^(+))及炎症相关指标[Toll样受体4(TLR4)、高迁移率族蛋白B1(HMGB1)、C反应蛋白(CRP)]。结果观察组治疗有效率高于对照组,差异有统计学意义(P<0.05)。治疗后,两组FVC、PEF、FEV_(1)、SaO_(2)、PaO_(2)及CD4^(+)、CD3^(+)水平和CD4^(+)/CD8^(+)比值均升高,且观察组高于对照组,差异均有统计学意义(P<0.05);两组PaCO_(2)及CD8^(+)、TLR4、HMGB1、CRP水平均降低,且观察组低于对照组,差异均有统计学意义(P<0.05)。结论替加环素联合盐酸氨溴索纤维支气管镜肺泡灌洗治疗重症肺炎有较好疗效,可改善肺功能及动脉血气指标,减轻炎症反应,提高免疫功能。
Objective To investigate the efficacy of tigecycline combined with ambroxol hydrochloride bronchoscopyassisted bronchoalveolar lavage in the treatment of severe pneumonia.Methods A total of 60 patients with severe pneumonia admitted to Yucheng County People’s Hospital from March 2021 to March 2024 were enrolled and randomly assigned by a random number table method to a control group and an observation group(30 patients in each group).The control group received ambroxol hydrochloride bronchoalveolar lavage via fiberoptic bronchoscopy.while the observation group additionally received intravenous infusion of tigecycline for injection on the basis of the control treatment.Treatment efficacy was evaluated after 7 days in both groups.Pulmonary function indices[forced expiratory volume in 1 second(FEV1).peak expiratory flow(PEF).and forced vital capacity(FVC)],arterial blood gas indices[partial pressure of carbon dioxide(PaCO_(2)).oxygen saturation(SaO_(2)).and partial pressure of oxygen(PaO_(2))],immune indices(CD8^(+).CD4^(+).CD3^(+).and CD4^(+)/CD8^(+)).and inflammation-related indices[Toll-like receptor 4(TLR4).high-mobility group box 1(HMGB1).and C-reactive protein(CRP)],were compared between the two groups.Results The overall response rate was higher in the observation group than in the control group.with a statistically significant difference(P<0.05).After treatment.FVC.PEF.FEV1.SaO_(2).PaO_(2).CD4^(+).CD3^(+).and the CD4^(+)/CD8^(+)ratio increased in both groups.and all were higher in the observation group than in the control group(P<0.05).PaCO_(2) as well as CD8^(+).TLR4.HMGB1.and CRP levels decreased in both groups.and all were lower in the observation group than in the control group(P<0.05).Conclusion Tigecycline combined with ambroxol hydrochloride bronchoscopy-assisted bronchoalveolar lavage shows good efficacy in treating severe pneumonia.It can improve pulmonary function and arterial blood gas parameters.alleviate inflammatory responses.and enhance immune function.
作者
刘钊
曾曼
韩盼盼
LIU Zhao;ZENG Man;HAN Panpan(Department of Respiratory Medicine,Yucheng County People’s Hospital,Shangqiu Henan 476300,China)
出处
《临床研究》
2026年第2期46-49,共4页
Clinical Research
关键词
重症肺炎
替加环素
盐酸氨溴索
纤维支气管镜肺泡灌洗
severe pneumonia
tigecycline
ambroxol hydrochloride
fiberoptic bronchoscopy-assisted bronchoalveolar lavage
