目的 探討喜炎平注射液聯(lián)合亞胺培南西司他丁鈉治療老年重癥肺炎的臨床療效。方法 選取2021年4月—2023年3月天津市寶坻區(qū)人民醫(yī)院收治的96例老年重癥肺炎患者，按隨機數(shù)字表法將所有患者分為對照組和治療組，每組各48例。對照組靜脈滴注注射用亞胺培南西司他丁鈉，每次將0.5 g用5%葡萄糖注射液100 mL調配為濃度為5 mg/mL的藥液，3次/d。治療組在對照組基礎上靜脈滴注喜炎平注射液，每次將500 mg加入5%葡萄糖注射液250 mL，1次/d。兩組療程均為14 d。觀察兩組臨床療效和臨床表現(xiàn)消失時間，比較治療前后兩組肺炎胸片吸收評價量表（PCRAES）評分、臨床肺部感染評分（CPIS）、呼吸頻率（RR）、氧合指數(shù)（OI）及外周血中性粒細胞與淋巴細胞比值（NLR）、C反應蛋白（CRP）和血清降鈣素原（PCT）、白細胞介素-6（IL-6）水平。結果 治療后，治療組患者總有效率是93.75%，顯著高于對照組的79.17%（P＜0.05）。治療組咳嗽、發(fā)熱、胸悶痛、肺部啰音消失時間均顯著短于對照組（P＜0.05）。治療后，兩組PCRAES、CPIS評分均較治療前顯著降低（P＜0.05）；且以治療組降低更顯著（P＜0.05）。治療后，兩組RR均顯著下降，而OI均顯著增高（P＜0.05）；治療后，治療組RR顯著低于對照組，OI顯著高于對照組（P＜0.05）。治療后，兩組外周血NLR、CRP和血清PCT、IL-6水平均顯著下降（P＜0.05）；且以治療組下降更顯著（P＜0.05）。結論 喜炎平注射液聯(lián)合亞胺培南西司他丁鈉治療老年重癥肺炎具有較好的臨床療效，能有效促進患者癥狀體征緩解，抑制肺部感染及全身炎癥狀態(tài)，改善呼吸功能，值得臨床推廣應用。

Objective To explore the clinical efficacy of Xiyanping Injection combined with imipenem cilastatin sodium in treatment of severe pneumonia in the elderly. Methods A total of 96 elderly patients with severe pneumonia admitted to Tianjin Baodi District People’s Hospital from April 2021 to March 2023 were selected and divided into control group and treatment group according to random number table method, with 48 cases in each group. Patients in the control group were iv administered with Imipenem and Cilastatin Sodium for injection, 0.5 g was prepared with 5% glucose injection 100 mL into a concentration of 5 mg/mL, 3 times daily. Patients in the treatment group were iv administered with Xiyanping Injection on the basis of the control group, 500 mg was added to 5% glucose injection 250 mL, once daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacy and disappearance time of various clinical manifestations were evaluated, and the PCRAES score, clinical pulmonary infection score (CPIS), respiratory rate (RR), oxygenation index (OI), peripheral blood neutrophil to lymphocyte ratio (NLR), C-reactive protein (CRP), serum pro calcitonin (PCT) and interleukin-6 (IL-6) levels were compared between the two groups before and after treatment. Results After treatment, the total effective rate of the treatment group was 93.75%, which was significantly higher than that of the control group (79.17%, P< 0.05). The disappearance time of cough, fever, chest pain and lung rales in the treatment group was significantly shorter than that in the control group (P < 0.05). After treatment, PCRAES and CPIS scores in both groups were significantly decreased compared with those before treatment (P < 0.05). The decrease was more significant in the treatment group (P < 0.05). After treatment, RR decreased significantly, while OI increased significantly in both groups (P< 0.05). After treatment, RR and OI in treatment group were significantly lower than those in control group (P < 0.05). After treatment, the levels of peripheral blood NLR, CRP and serum PCT and IL-6 were significantly decreased in both groups (P < 0.05). The decrease was more significant in the treatment group (P < 0.05). Conclusion Xiyanping Injection combined with imipenem cilastatin sodium has good clinical efficacy in treatment of severe pneumonia in the elderly, and can effectively promote the relief of symptoms and signs, also can inhibit lung infection and systemic inflammation, and can improve respiratory function, which is worthy of clinical application.

R974

天津市衛(wèi)生健康重點學科專項項目（TJWJ2022XK035）