目的 探討胸腺肽聯(lián)合頭孢哌酮鈉舒巴坦治療呼吸機(jī)相關(guān)肺炎臨床療效。方法 選取十堰市太和醫(yī)院2015年4月—2017年4月收治的呼吸機(jī)相關(guān)肺炎患者154例，隨機(jī)分為對照組（77例）和治療組（77例）。對照組患者靜脈滴注注射用頭孢哌酮鈉舒巴坦鈉，3 g加入100 mL生理鹽水，1次/8 h。治療組在對照組基礎(chǔ)上靜脈滴注注射用胸腺肽，80 mg加入500 mL生理鹽水，1次/d。兩組患者均治療14 d。觀察兩組患者臨床療效，比較治療前后兩組患者臨床癥狀消失時間、住院時間和啰音消失時間、體溫、白細(xì)胞計(jì)數(shù)（WBC）、中性粒細(xì)胞比例（NEUT%）水平及血清降鈣素原（PCT）、高敏C反應(yīng)蛋白（hs-CRP）、白細(xì)胞介素-6（IL-6）和外周血淋巴細(xì)胞水平。結(jié)果 治療后，對照組和治療組臨床總有效率分別為71.43%和85.71%，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，治療組患者臨床癥狀消失時間、住院時間和啰音消失時間均顯著短于對照組（P<0.05）。治療后，兩組患者患者體溫、WBC、NEUT%水平均明顯降低（P<0.05）；且治療組患者上述指標(biāo)明顯低于對照組（P<0.05）。治療后，兩組血清PCT、hs-CRP、IL-6水平顯著降低（P<0.05）；且治療組患者治療后血清PCT、hs-CRP、IL-6水平明顯低于對照組（P<0.05）。治療后，治療組外周血CD³⁺、CD⁴⁺T淋巴細(xì)胞、CD⁴⁺/CD⁸⁺水平明顯升高（P<0.05），CD⁸⁺T淋巴細(xì)胞水平明顯降低（P<0.05）；且治療組患者治療后上述外周血淋巴細(xì)胞水平明顯好于對照組（P<0.05）。結(jié)論 胸腺肽聯(lián)合頭孢哌酮鈉舒巴坦治療呼吸機(jī)相關(guān)肺炎能有效縮短病程，改善血常規(guī)指標(biāo)，提高免疫功能，具有一定的臨床推廣應(yīng)用價值。

Objective To investigate the clinical efficacy of thymic peptide combined with cefoperazone sodium and sulbactam sodium in treatment of ventilator-associated pneumonia. Methods Patients (154 cases) with ventilator-associated pneumonia in Taihe Hospital from April 2015 to April 2017 were randomly divided into control (77 cases) and treatment (77 cases). Patients in the control group were iv administered with Cefoperazone Sodium and Sulbactam Sodium for injection, 3 g added into normal saline 100 mL, once every 8 h. Patients in the treatment group were iv administered with Thymopetidum for injection on the basis of the control group, 80 mg added into normal saline 500 mL, once daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacy was evaluated, and the disappearance time of clinical symptoms and pulmonary rales, the hospitalization time, temperature, WBC, NEUT%, the serum PCT, hs-CRP and IL-6, the peripheral blood lymphocyte levels in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups were 71.43% and 85.71% respectively, and there were differences between two groups (P < 0.05). After treatment, the disappearance time of clinical symptoms and pulmonary rales, the hospitalization time in the treatment group was significantly shorter than that in the control group (P < 0.05). After treatment, the temperature, WBC and NEUT% in two groups were significantly decreased (P < 0.05). And these indicators in the treatment group after treatment were significantly lower than those in the control group (P < 0.05). After treatment, the PCT, hs-CRP and IL-6 levels in two groups were significantly decreased (P < 0.05). And the PCT, hs-CRP and IL-6 levels in the treatment group after treatment were significantly lower than those in the control group (P < 0.05). After treatment, the CD³⁺, CD⁴⁺ and CD⁴⁺/CD⁸⁺ levels in two groups were significantly increased, but the CD⁸⁺ levels were significantly decreased (P < 0.05). And the peripheral blood lymphocyte levels in the treatment group after treatment were significantly better than those in the control group (P < 0.05). Conclusion Thymic peptide combined with cefoperazone sodium and sulbactam sodium in treatment of ventilator-associated pneumonia can effectively shorten disease course, improve blood routine indexes and immune function, which has a certain clinical application value.

湖北省自然科學(xué)基金資助項(xiàng)目（2010CDB09103）