头孢哌酮/舒巴坦和左氧氟沙星治疗老年社区获得性肺炎的效果对比及对炎性因子水平的影响

梁秀胡+蓝能+周艳吉

【摘要】 目的 研究并对比头孢哌酮/舒巴坦、左氧氟沙星治疗老年社区获得性肺炎的临床效果及其对患者机体内炎性因子水平的影响。

方法 于2013年5月～2016年4月，选取收治的100例老年社区获得性肺炎患者作为研究对象，按照随机数字表分为对照组、观察组，每组50例。对照组采用左氧氟沙星治疗，观察组采用头孢哌酮/舒巴坦治疗。比较两组患者的临床总有效率、咳嗽消失时间、退热时间，并对两组患者治疗前后的炎性因子（C反应蛋白、白细胞）变化情况进行比较。

结果 观察组的临床总有效率为96.0%，与对照组相比差异有统计学意义（P<0.05）。与对照组相比，观察组的咳嗽消失时间、退热时间均明显缩短（P<0.001）。治疗后，观察组的C反应蛋白水平、白细胞计数均明显下降（P<0.001），且观察组治疗后下降更明显（P<0.001）。

结论 头孢哌酮/舒巴坦治疗老年社区获得性肺炎疗效较左氧氟沙星更加显著，且其还能更加有效地抑制患者机体内的炎性因子水平。

【关键词】 老年社区获得性肺炎；左氧氟沙星；头孢哌酮/舒巴坦；炎性因子

中图分类号：R563.1 文献标识码：A DOI：10.3969/j.issn.1003-1383.2017.03.016

【Abstract】 Objective To study and compare the clinical effects of cefoperazone/shubatan and levofloxacin in the treatment of elderly patients with community acquired pneumonia（CAP） and its influence on the levels of inflammatory factors in the patients.

Methods A total of 100 elderly patients with CAP admitted to hospital from May，2013 to April，2016 were selected and divided into control group and observation group according to the random number table method，with 50 cases in each group.The control group were given levofloxacin，and the observation group were treated with cefoperazone/shubatan.And then，total effective rate，cough disappearance time and fever clearance time as well as changes of inflammatory factors （C-reactive proteins and white blood cells） before and after treatment were compared between the two groups.

Results The total effective rate of the observation group was 96.0%，compared with that of the control group，difference was statistically significant（P<0.05）.Compared with the control group，the cough disappearance time and fever clearance time of the observation group significantly shortened （P<0.001）.In addition，the levels of C-reactive proteins and white blood cells after treatment significantly decreased（P<0.001），and that of the observation group decreased more significantly（P<0.001）.

Conclusion Cefoperazone/sulbactam is more effective than levofloxacin in the treatment of elderly patients with CAP，and it can also effectively inhibit the levels of inflammatory factors in the patients.

【Key words】 elderly patients with CAP；levofloxacin；cefoperazone/shubatan；inflammatory factor

社區获得性肺炎（community acquired pneumonia，CAP）主要是指在医院外因致病菌入侵呼吸道引起的肺实质性炎症病变，临床表现以高热、咳嗽为主，部分患者伴随有咳痰，在老年人群中发病率较高，患者机体内的炎性因子水平往往随着肺部炎症病变的发展而逐渐增高，部分患者还有可能发展为感染性休克，导致死亡[1～2]。因此，临床上应对老年社区获得性肺炎患者进行积极有效的治疗，以控制患者的病情，抑制患者机体内的炎性因子水平。……