目的 探討喜炎平注射液聯(lián)合比阿培南治療重癥肺炎的臨床效果。方法 選取2019年3月—2022年3月天津市第五中心醫(yī)院收治的118例重癥肺炎患者，按隨機(jī)數(shù)字表法將所有患者分成對(duì)照組和治療組，每組各59例。對(duì)照組靜脈滴注注射用比阿培南，每次將0.3g溶于100mL生理鹽水中，滴注30～60min，2次/d。治療組在對(duì)照組基礎(chǔ)上靜脈滴注喜炎平注射液，每次將500mg加入250mL生理鹽水中，1次/d。兩組連續(xù)治療14d。觀察兩組的臨床療效和典型表現(xiàn)（發(fā)熱、咳嗽、胸悶痛、肺部啰音、白細(xì)胞異常）消失時(shí)間。比較治療前后兩組臨床肺部感染評(píng)分（CPIS）、急性生理功能和慢性健康狀況評(píng)分系統(tǒng)Ⅱ（APACHEⅡ）評(píng)分及血清C反應(yīng)蛋白（CRP）、降鈣素原（PCT）、可溶性細(xì)胞間黏附分子-1（sICAM-1）、白細(xì)胞介素（IL）-17、基質(zhì)金屬蛋白酶-9（MMP-9）水平。結(jié)果 治療后，治療組總有效率為93.2%，顯著高于對(duì)照組的81.4%（P＜0.05）。治療后，治療組發(fā)熱、咳嗽、胸悶痛、肺部啰音、白細(xì)胞異常的消失時(shí)間均較對(duì)照組顯著縮短（P＜0.05）。治療后，兩組CPIS評(píng)分和APACHEⅡ評(píng)分均較治療前顯著降低（P＜0.05）；且均以治療組下降更顯著（P＜0.05）。治療后，兩組血清CRP、PCT、sICAM-1、IL-17、MMP-9水平均較治療前顯著下降（P＜0.05）；且均以治療組降低更顯著（P＜0.05）。結(jié)論 喜炎平注射液聯(lián)合比阿培南治療重癥肺炎的總體療效滿(mǎn)意，能迅速緩解患者癥狀及體征，減輕肺部感染及全身炎癥反應(yīng)，改善組織器官損傷，促進(jìn)病情恢復(fù)，且安全性較好。

Objective To investigate the clinical effect of Xiyanping Injection combined with biapenem in treatment of severe pneumonia. Methods A total of 118 patients with severe pneumonia admitted to Tianjin Fifth Central Hospital from March 2019 to March 2022 were selected and divided into control group and treatment group according to the random number table method, with 59 cases in each group. Patients in the control group were iv administered with Biapenem for injection, 0.3g was dissolved in 100 mL normal saline and injected for 30-60 min, twice daily. Patients in the treatment group were iv administered with Xiyanping Injection on the basis of the control group, 500 mg was added to 250 mL normal saline once daily. The two groups were treated for 14 d. The clinical efficacy and disappearance time of typical manifestations (fever, cough, chest tightness and pain, lung rales, abnormal white blood cells) of the two groups were observed. The clinical pulmonary infection score (CPIS), acute physiological function and chronic health evaluation System Ⅱ (APACHEⅡ) score, serum C-reactive protein (CRP), procalcitonin (PCT), soluble intercellular adhesion molecular 1 (sICAM-1), interleukin (IL)-17, and matrix metalloproteinase-9 (MMP-9) were compared between the two groups before and after treatment level. Results After treatment, the total effective rate of the treatment group was 93.2%, which was significantly higher than that of the control group (81.4%, P<0.05). After treatment, the disappearance time of fever, cough, chest tightness and pain, lung rales and white blood cell abnormalities in the treatment group were significantly shorter than those in the control group (P<0.05). After treatment, the CPIS score and APACHEⅡ score of the two groups were significantly lower than those before treatment (P<0.05). The decrease was more significant in the treatment group (P<0.05). After treatment, the serum levels of CRP, PCT, sICAM-1, IL-17 and MMP-9 in the two groups were significantly decreased compared with those before treatment (P<0.05). And the reduction was more significant in the treatment group (P<0.05). Conclusion Xiyanping Injection combined with biapenem has a satisfactory overall efficacy in the treatment of severe pneumonia, and can quickly relieve the symptoms and signs of patients, reduce lung infection and systemic inflammation, improve tissue and organ damage, promote disease recovery, which has good safety.

R974

國(guó)家自然科學(xué)基金項(xiàng)目（81900407）