哌拉西林钠/他唑巴坦联合莫西沙星治疗COPD合并急性下呼吸道感染

　　【摘要】 目的：探讨哌拉西林钠/他唑巴坦联合莫西沙星治疗慢性阻塞性肺疾病（chronic obstructive pulmonary diseases，COPD）合并急性下呼吸道感染患者的临床疗效。方法：选取COPD合并急性下呼吸道感染患者120例，按照随机数字表法将其分为对照1组（哌拉西林钠/他唑巴坦）、对照2组（莫西沙星）和联合治疗组（哌拉西林钠/他唑巴坦+莫西沙星），每组各40例。比较三组治疗前后的急性生理与慢性健康评分（APACHEⅡ）及呼吸困难评分，比较三组患者经治疗后的细菌清除率及临床疗效。结果：治疗后，联合治疗组患者APACHEⅡ与呼吸困难评分均明显低于对照1、2组，比较差异均有统计学意义（P<0.05）；三组患者治疗后病原菌株数均有所下降，联合治疗组细菌清除率为91.6%（33/36），均高于对照1、2组的62.6%（23/37）、64.8%（24/37），比较差异有统计学意义（ 字2=9.746，P=0.008）；联合治疗组总有效率为87.5%，均高于对照1、2组的57.5%、55.0%，比較差异有统计学意义（ 字2=9.691，P=0.008）。结论：合理联合使用抗生素治疗COPD合并急性下呼吸道感染可减少不必要的细菌侵入，改善其预后。
　　【关键词】 哌拉西林钠/他唑巴坦； 莫西沙星； 慢性阻塞性肺疾病； 感染
　　Piperacillin Sodium/Tazobactam Combined with Moxifloxacin in Treatment of COPD with Acute Lower Respiratory Tract Infection/SUN Wenjun.//Medical Innovation of China，2018，15（07）：017-020
　　【Abstract】 Objective：To investigate the clinical efficacy of Piperacillin Sodium/Tazobactam combined with Moxifloxacin in treatment of chronic obstructive pulmonary disease（COPD） with acute lower respiratory tract infection.Method：A total of 120 patients with COPD with acute lower respiratory tract infection were selected.According to the random number table method，they were divided into control 1 group（Piperacillin Sodium/Tazobactam），control 2 group（Moxifloxacin） and combined treatment group（Piperacillin Sodium/Tazobactam+Moxifloxacin），40 cases in each group.The acute physiology and chronic health score（APACHEⅡ） and dyspnea score before and after treatment in three groups were compared，the bacterial clearance rate，and clinical efficacy of three groups after treatment were compared.Result：After treatment，the scores of APACHE Ⅱ and dyspnea in combined treatment group were significantly lower than those of control 1 and 2 group，the difference was statistically significant（P<0.05）.The number of pathogens in three groups decreased after treatment，the bacterial clearance rate in combined treatment group was 91.6%（33/36），which was higher than 62.6%（23/37） and 64.8%（24/37） in the control 1 and 2 group，the difference was statistically significant（ 字2=9.746，P=0.008）.The total effective rate of combined treatment group was 87.5%，which was higher than 57.5% and 55.0% in control group 1 and 2 group，the difference was statistically significant（ 字2=9.691，P=0.008）.Conclusion：Rational combination of antibiotics in treatment of COPD with acute lower respiratory tract infection can reduce the unnecessary bacterial invasion and improve its prognosis.
　　【Key words】 Piperacillin Sodium/Tazobactam； Moxifloxacin； Chronic obstructive pulmonary disease； Infection

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