美罗培南联合左氧氟沙星对重症脓毒症休克患者的疗效观察

摘要/Abstract

摘要： 目的探讨美罗培南联合左氧氟沙星对重症脓毒症休克患者的临床疗效。方法回顾性选取恩施市中心医院2021年1月—2022年6月收治的100例重症脓毒症休克患者作为研究对象,根据治疗方法将所有重症脓毒症休克患者分为观察组（47例）与对照组（53例）。所有患者均给予营养支持、维持水电解质平衡、抗感染等常规治疗。对照组在常规治疗基础上静脉滴注美罗培南,观察组在常规治疗基础上采取美罗培南联合左氧氟沙星静脉滴注,对比两组患者临床疗效、炎症因子水平、血尿素氮（BUN）水平、血清肌酐（Scr）水平、丙氨酸氨基转移酶（ALT）水平、天冬氨酸氨基转移酶（AST）水平、乳酸水平、肌酸激酶（CK）表达水平以及免疫功能变化。结果观察组治疗总有效率明显高于对照组（P<0.05）;治疗后,对照组C反应蛋白（CRP）、降钙素原（PCT）、白细胞计数等相关炎症因子水平降低,且观察组明显低于对照组（P<0.05）;治疗后,两组BUN、Scr、ALT、AST、乳酸、CK水平均降低,且观察组明显低于对照组（P<0.05）;治疗后,两组CD4⁺、CD3⁺和CD4⁺/ CD8⁺数值均升高,且观察组高于对照组（P<0.05）。结论对重症脓毒症休克患者采取美罗培南联合左氧氟沙星治疗能够减轻患者临床症状,提升治疗效果,降低炎症因子水平,减轻休克对患者肾功能、心功能、肝功能带来的损伤,降低休克严重程度,提升患者免疫功能。

关键词: 美罗培南, 左氧氟沙星, 重症脓毒症, 休克, 炎症因子

Abstract: Objective To investigate the clinical efficacy of Meropenem combined with Levofloxacin in patients with severe septic shock. Methods 100 patients with severe septic shock from January 2021 to June 2022 in Enshi City Central Hospital were selected as research objects, according to the treatment of all severe septic shock patients were divided into observation group (n=47) and control group (n=53). All patients were given nutritional support, water-electrolyte balance, and anti-infection. The control group received intravenous drip of Meropenem on the basis of conventional treatment, and the observation group received intravenous drip of Meropenem combined with Levofloxacin on the basis of conventional treatment. The clinical efficacy, levels of inflammatory factors, levels of blood urea nitrogen (BUN), serum creatinine (Scr), alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate, creatine kinase (CK) and adverse reactions of the two groups were compared. Results The total effective rate of observation group was significantly higher than that of control group (P<0.05). After treatment, the levels of C-reactive protein (CRP), procalcitonin (PCT) and WBC count-related inflammatory factors in the control group were decreased, and the observation group was significantly lower than the control group (P<0.05). After treatment, BUN, Scr, ALT, AST, lactic acid and CK levels were decreased, and observation group was significantly lower than control group (P<0.05). After treatment, the values of CD4⁺, CD3⁺ and CD4⁺/ CD8⁺ in both groups were increased, and the observation group was higher than the control group (P<0.05). ConclusionMeropenem combined with Levofloxacin in the treatment of severe septic shock patients can reduce the clinical symptoms of patients, improve the therapeutic effect, reduce the level of inflammatory factors, reduce the damage caused by shock to the kidney function, heart function and liver function of patients, reduce the severity of shock, and improve the immune function of patients.

Key words: meropenem, levofloxacin, severe sepsis, shock, inflammatory factor

中图分类号:

R978.1

彭正红, 鄢忠平. 美罗培南联合左氧氟沙星对重症脓毒症休克患者的疗效观察[J]. 中华养生保健, 2023, 41(6): 15-18.

PENG Zheng-hong, YAN Zhong-ping. Efficacy Observation of Meropenem combined with Levofloxacin in Patients with Severe Septic Shock[J]. ZHONGHUA YANGSHENG BAOJIAN, 2023, 41(6): 15-18.

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